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General NPI Number Information
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NPI Number | 1255433421
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Entity Type | Individual
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Provider Name | STEVEN KEITH BAUM PHD
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Gender | Male
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 12/08/2019
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Provider Practice Location Address
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Address Line | 3620 WYOMING BLVD NE STE 112
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-3288
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Country | US
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Telephone | 505-918-2750
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Fax | 505-214-5897
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Provider Business Mailing Address
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Address Line | 3620 WYOMING BLVD NE STE 112
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-3288
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Country | US
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Telephone | 505-918-2750
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Fax | 505-508-5438
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | MI 5686
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0949NEWMEXICO
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License Number State | NM
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