MEDICARE: DR. RICHARD ALAN BAUM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	59992	TN
2	207RG0100X	Gastroenterology Physician	D13526	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	35442505	OTHER	MD	BC BS OF MD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1470001	OTHER	MD	BC BS OF MD

General Provider Information

NPI Number	:	1104888254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD ALAN BAUM MD

Provider Business Mailing Address
First Line	:	1600 CRAIN HWY
Second Line	:	STE 410
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-6437
Country	:	US
Telephone Number	:	410-766-2500
Fax Number	:	410-766-2507

Provider Business Practice Location Address
First Line	:	1600 CRAIN HWY
Second Line	:	STE 410
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-6437
Country	:	US
Telephone Number	:	410-766-2500
Fax Number	:	410-766-2507

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2006
Last Update Date	:	06/24/2020

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