Provider Demographics
NPI:1508350265
Name:BAUGHMAN, DOUGLAS MASON (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:MASON
Last Name:BAUGHMAN
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 1:1500 E MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-5000
Mailing Address - Country:US
Mailing Address - Phone:734-936-4280
Mailing Address - Fax:
Practice Address - Street 1:2900 12TH AVE N STE 205W
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-7520
Practice Address - Country:US
Practice Address - Phone:406-254-0707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-17
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301114689390200000X
MT106274207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program