Provider Demographics
NPI:1235261728
Name:BAUM, JAMES EMIL (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EMIL
Last Name:BAUM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1850 OLD PECOS TRL STE L
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4760
Mailing Address - Country:US
Mailing Address - Phone:505-989-8647
Mailing Address - Fax:505-983-6464
Practice Address - Street 1:1850 OLD PECOS TRL STE L
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4760
Practice Address - Country:US
Practice Address - Phone:505-989-8647
Practice Address - Fax:505-983-6464
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMA592-72204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine