Provider Demographics
NPI:1346305182
Name:BAUM, CARL A (MD)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:A
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 1:906 W 2ND AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-4538
Mailing Address - Country:US
Mailing Address - Phone:509-458-5889
Mailing Address - Fax:509-624-1216
Practice Address - Street 1:906 W 2ND AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-4538
Practice Address - Country:US
Practice Address - Phone:509-458-5889
Practice Address - Fax:509-624-1216
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000182942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5899BAOtherBLUE SHIELD #
WAA7528OtherBLUE CROSS #
WAMD00018294OtherLICENSE
WAMD00018294OtherLICENSE
WAMD00018294OtherLICENSE