Provider Demographics
NPI:1154317451
Name:BAUM, RICHARD ARTHUR (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:ARTHUR
Last Name:BAUM
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 FRANCIS ST
Mailing Address - Street 2:RADIOLOGY, BRIGHAM AND WOMEN'S HOSPITAL
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6110
Mailing Address - Country:US
Mailing Address - Phone:617-732-7263
Mailing Address - Fax:617-277-8331
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:RADIOLOGY, BRIGHAM AND WOMEN'S HOSPITAL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-732-7263
Practice Address - Fax:617-277-8331
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2127972085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0161594Medicaid
MAJ34482OtherBLUE CROSS/BLUE SHIELD
MA212797OtherTUFTS HEALTH CARE
MAF53944OtherHARVARD PILGRIM
MAF53944Medicare UPIN
MAJ34482OtherBLUE CROSS/BLUE SHIELD