Provider Demographics
NPI:1568427896
Name:BAUM, KENNETH FRANCIS (MD)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:FRANCIS
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 1:73 JASMINE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-5910
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:303-377-2671
Practice Address - Street 1:2535 S DOWNING ST
Practice Address - Street 2:SUITE 340
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5847
Practice Address - Country:US
Practice Address - Phone:303-991-1993
Practice Address - Fax:303-377-2119
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO26007207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01260074Medicaid
COD24731Medicare UPIN
COF70950Medicare ID - Type Unspecified