MEDICARE: DR. ALICIA BAUM 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	207NS0135X	Procedural Dermatology Physician	MD019988E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000048869	OTHER	PA	HIGHMARK BLUE SHIELD
2	1010403	OTHER	PA	GATEWAY HEALTH PLAN
3	45688	OTHER	PA	HEALTH AMERICA/ASSURANCE
4	534192	OTHER	PA	AETNA
5	204024	OTHER	PA	UPMC HEALTH PLANS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	66358	OTHER	PA	MEDPLUS

General Provider Information

NPI Number	:	1265439772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALICIA BAUM M.D.

Provider Business Mailing Address
First Line	:	8700 PENNSYLVANIA AVE
Second Line	:
City	:	NORTH HUNTINGDON
State	:	PA
Zip	:	15642-2762
Country	:	US
Telephone Number	:	724-863-7530
Fax Number	:	724-863-8213

Provider Business Practice Location Address
First Line	:	8700 PENNSYLVANIA AVE
Second Line	:
City	:	NORTH HUNTINGDON
State	:	PA
Zip	:	15642-2762
Country	:	US
Telephone Number	:	724-863-7530
Fax Number	:	724-863-8213

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	08/26/2010

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Directions to “ DR. ALICIA BAUM M.D.” Practice Location

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