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General NPI Number Information
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NPI Number | 1295944080
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Entity Type | Individual
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Provider Name | THOMAS L BAUMGARDNER PHD
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Gender | Male
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 01/07/2021
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Provider Practice Location Address
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Address Line | 8422 BELLONA LN SUITE 205
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City | TOWSON
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State | MD
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Zip | 21204-2048
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Country | US
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Telephone | 410-583-0011
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Fax | 410-583-0012
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Provider Business Mailing Address
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Address Line | 8422 BELLONA LN STE 207
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City | TOWSON
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State | MD
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Zip | 21204-2057
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Country | US
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Telephone | 410-583-0011
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Fax | 410-583-0012
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 03177
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License Number State | MD
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