MEDICARE: DR. ERIC BRET BAUD M.D.

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	207N00000X	Dermatology Physician	35065990	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	070011004	OTHER	OH	MEDICARE RAILROAD

Other Identifiers

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

General Provider Information

NPI Number	:	1265431654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC BRET BAUD M.D.

Provider Business Mailing Address
First Line	:	2248 COVENTRY RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-3547
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 SEVERANCE CIR
Second Line	:	SUITE 205
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-1566
Country	:	US
Telephone Number	:	216-382-7072
Fax Number	:	216-691-3944

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

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	05/05/2015

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