MEDICARE: DR. MARC N BASKIN 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	208000000X	Pediatrics Physician	56177	MA
2	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	56177	MA

Other Identifiers

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

General Provider Information

NPI Number	:	1598729451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARC N BASKIN MD

Provider Business Mailing Address
First Line	:	300 LONGWOOD AVE
Second Line	:	CHILDREN'S HOSPITAL EMERGENCY DEPARTMENT
City	:	BOSTON
State	:	MA
Zip	:	02115-5724
Country	:	US
Telephone Number	:	617-355-6624
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 LONGWOOD AVE
Second Line	:	CHILDREN'S HOSPITAL EMERGENCY DEPARTMENT
City	:	BOSTON
State	:	MA
Zip	:	02115-5737
Country	:	US
Telephone Number	:	617-355-6624
Fax Number	:

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

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	08/18/2015

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