Provider Demographics
NPI:1205860970
Name:BAUMAN, TED ALBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:TED
Middle Name:ALBERT
Last Name:BAUMAN
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 1:403 FAIRVIEW ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-2399
Mailing Address - Country:US
Mailing Address - Phone:910-592-6011
Mailing Address - Fax:
Practice Address - Street 1:403 FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-2399
Practice Address - Country:US
Practice Address - Phone:910-592-6011
Practice Address - Fax:910-592-0819
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2001-00305207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCA8688OtherMEDCOST
NC560955090OOtherCIGNA
NC7371344OtherAETNA
NC89129F1Medicaid
NC0101118OtherUNITED HEALTHCARE
NC129F1OtherNC BLUE CROSS BLUE SHIELD
NC00342167Medicaid
NC129F1OtherNC BLUE CROSS BLUE SHIELD