Provider Demographics
NPI:1467413757
Name:BAUGHN, STEVEN P (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:P
Last Name:BAUGHN
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:PO BOX 8500-6335
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:215-493-0100
Mailing Address - Fax:215-493-7528
Practice Address - Street 1:680 HEACOCK RD
Practice Address - Street 2:SUITE 205
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-6346
Practice Address - Country:US
Practice Address - Phone:215-493-0100
Practice Address - Fax:215-493-7528
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD026224E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA469360OtherHIGHMARK BLUE SHIELD
PA30050542OtherKEYSTONE MERCY
PA4058531OtherAETNA
PA1018447400002Medicaid
PA4058531OtherAETNA
PA30050542OtherKEYSTONE MERCY