Provider Demographics
NPI:1477633600
Name:BAUMAN, JOEL S (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:S
Last Name:BAUMAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 415348 UMASS MEMORIAL MEDICAL GROUP INC
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:002-258-8858
Mailing Address - Fax:508-334-1977
Practice Address - Street 1:55 LAKE AVE N
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01655-0002
Practice Address - Country:US
Practice Address - Phone:508-334-8630
Practice Address - Fax:774-441-6710
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2020-11-16
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Provider Licenses
StateLicense IDTaxonomies
MA58967207RG0300X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAE56632Medicare UPIN