MEDICARE: MAUREEN BAUMAN

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	2251X0800X	Orthopedic Physical Therapist	PT017292	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	296459	OTHER	CA	CALIFORNIA PHYSICAL THERAPY STATE LICENSE

General Provider Information

NPI Number	:	1629547708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUREEN BAUMAN

Provider Business Mailing Address
First Line	:	2379 MIRAMAR BLVD
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-3818
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 SEVERANCE CIR STE 115
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-1513
Country	:	US
Telephone Number	:	216-381-0300
Fax Number	:

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

Provider Enumeration Date	:	11/18/2018
Last Update Date	:	09/16/2021

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Directions to “ MAUREEN BAUMAN ” Practice Location

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