Provider Demographics
NPI:1659308898
Name:BAUMANN, MICHAEL H (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:H
Last Name:BAUMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2500 NORTH STATE STREET
Mailing Address - Street 2:DEPT OF MEDICINE/DIVISION OF PULMONARY
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4500
Mailing Address - Country:US
Mailing Address - Phone:601-984-5650
Mailing Address - Fax:601-984-5658
Practice Address - Street 1:2500 NORTH STATE STREET
Practice Address - Street 2:DEPARTMENT OF MEDICINE DIVISION OF PULMONARY
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4500
Practice Address - Country:US
Practice Address - Phone:601-984-5650
Practice Address - Fax:601-984-5658
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS14177207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0114211Medicaid
LA1687651Medicaid
MS302I298862Medicare PIN
MSA37600Medicare UPIN