Provider Demographics
NPI:1225371107
Name:TAD BAUM, M.D., P.C.
Entity Type:Organization
Organization Name:TAD BAUM, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TAD
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-534-2426
Mailing Address - Street 1:50 MEMORIAL DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-2238
Mailing Address - Country:US
Mailing Address - Phone:978-534-2426
Mailing Address - Fax:978-534-4711
Practice Address - Street 1:50 MEMORIAL DR
Practice Address - Street 2:SUITE 105
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2238
Practice Address - Country:US
Practice Address - Phone:978-534-2426
Practice Address - Fax:978-534-4711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-29
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA150333207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA151588OtherHARVARD PILGRIM
2135111OtherAETNA
0800773OtherUNITEED HEALTH CARE
40918OtherDAVIS VISION
MA150333OtherTUFTS
MA3150356Medicaid
J16528OtherBLUE CROSS BLUE SHIELD
MA977333OtherNETWORK HEALTH
B20757203OtherCIGNA
0800773OtherUNITEED HEALTH CARE
=========OtherUNICARE
=========OtherPRIVATE HEALTH CARE
MA=========OtherGIC
J16528OtherBLUE CROSS BLUE SHIELD
MA151588OtherHARVARD PILGRIM
MA=========OtherGIC