Provider Demographics
NPI:1073525887
Name:BARON, MICHAEL AUSTIN (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:AUSTIN
Last Name:BARON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 NEW HAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-4854
Mailing Address - Country:US
Mailing Address - Phone:203-878-5937
Mailing Address - Fax:203-878-9542
Practice Address - Street 1:75 NEW HAVEN AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-4854
Practice Address - Country:US
Practice Address - Phone:203-878-5937
Practice Address - Fax:203-878-9542
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT14458208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
E31745Medicare UPIN