Provider Demographics
NPI:1083650485
Name:BAUM, STEPHEN E (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:E
Last Name:BAUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1144 N 28TH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-0110
Mailing Address - Country:US
Mailing Address - Phone:406-238-6380
Mailing Address - Fax:406-238-6399
Practice Address - Street 1:1144 N 28TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0110
Practice Address - Country:US
Practice Address - Phone:406-238-6380
Practice Address - Fax:406-238-6399
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT7412207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0025806Medicaid
MT6611OtherBLUE CROSS BLUE SHIELD
MT6611OtherBLUE CROSS BLUE SHIELD
MT0025806Medicaid