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General NPI Number Information
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NPI Number | 1528284981
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Entity Type | Individual
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Provider Name | GERALD CHARLES BAUMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 910 E ASH ST
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City | CALDWELL
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State | ID
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Zip | 83605-5321
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Country | US
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Telephone | 208-459-1227
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Fax | 208-459-1227
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Provider Business Mailing Address
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Address Line | 910 E ASH ST
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City | CALDWELL
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State | ID
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Zip | 83605-5321
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Country | US
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Telephone | 208-459-1227
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Fax | 208-459-1227
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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 | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | M-2647
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License Number State | ID
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