Provider Demographics
NPI:1073640983
Name:BAUMAL, MURRAY H (OD)
Entity Type:Individual
Prefix:DR
First Name:MURRAY
Middle Name:H
Last Name:BAUMAL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:607 BOYLSTON ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-3604
Mailing Address - Country:US
Mailing Address - Phone:617-236-5500
Mailing Address - Fax:617-236-5505
Practice Address - Street 1:607 BOYLSTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-3604
Practice Address - Country:US
Practice Address - Phone:617-236-5500
Practice Address - Fax:617-236-5505
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4158152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAU92889Medicare UPIN