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NPI Code Detail

MEDICARE: DR. MICHELLE A BAUM MD

MEDICARE: DR. MICHELLE A 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
12080P0210XPediatric Nephrology Physician77307MA
2208000000XPediatrics Physician77307MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104897925
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHELLE A BAUM MD
Provider Business Mailing Address
First Line : 300 LONGWOOD AVE
Second Line :
City : BOSTON
State : MA
Zip : 02115-5724
Country : US
Telephone Number : 617-355-6000
Fax Number :
Provider Business Practice Location Address
First Line : 300 LONGWOOD AVE
Second Line :
City : BOSTON
State : MA
Zip : 02115-5724
Country : US
Telephone Number : 617-355-6129
Fax Number : 617-730-0569
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2006
Last Update Date : 04/28/2014

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Directions to “ DR. MICHELLE A BAUM MD” Practice Location

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