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General NPI Number Information
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NPI Number | 1225371107
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Entity Type | Organization
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Legal Business Name | TAD BAUM, M.D., P.C.
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Dates
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Enumeration Date | 03/29/2013
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Last Update Date | 03/29/2013
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Provider Practice Location Address
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Address Line | 50 MEMORIAL DR SUITE 105
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City | LEOMINSTER
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State | MA
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Zip | 01453-2238
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Country | US
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Telephone | 978-534-2426
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Fax | 978-534-4711
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Provider Business Mailing Address
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Address Line | 50 MEMORIAL DR SUITE 105
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City | LEOMINSTER
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State | MA
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Zip | 01453-2238
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Country | US
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Telephone | 978-534-2426
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Fax | 978-534-4711
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Authorized Official
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Title or Position | PRESIDENT
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Name | TAD DAVID BAUM
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Credential | M.D.
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Telephone | 978-534-2426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 150333
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License Number State | MA
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