Provider Demographics
NPI:1528038254
Name:NEIL BAUM MD
Entity Type:Organization
Organization Name:NEIL BAUM MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:BAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-891-8454
Mailing Address - Street 1:3525 PRYTANIA ST
Mailing Address - Street 2:SUITE 614
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3500
Mailing Address - Country:US
Mailing Address - Phone:504-891-8454
Mailing Address - Fax:504-891-8505
Practice Address - Street 1:3525 PRYTANIA ST
Practice Address - Street 2:SUITE 614
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3500
Practice Address - Country:US
Practice Address - Phone:504-891-8454
Practice Address - Fax:504-891-8505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.04724R208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1197327Medicaid
LA=========OtherTAX ID
LA1197327Medicaid
LAB62357Medicare UPIN