Healthcare Provider Details

I. General information

NPI: 1891113254
Provider Name (Legal Business Name): LAUREN BAUMANN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN ST
CINCINNATI OH
45219-2364
US

IV. Provider business mailing address

307 W 4TH AVE
FLINT MI
48503-2401
US

V. Phone/Fax

Practice location:
  • Phone: 513-558-5861
  • Fax:
Mailing address:
  • Phone: 248-330-1974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number13421656-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: