Provider Demographics
NPI:1922164813
Name:BAUM, SUZANNE C (CPNP)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:C
Last Name:BAUM
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 DUTCHMANS LN
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-3346
Mailing Address - Country:US
Mailing Address - Phone:410-763-8272
Mailing Address - Fax:410-763-6014
Practice Address - Street 1:606 DUTCHMANS LN
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3346
Practice Address - Country:US
Practice Address - Phone:410-763-8272
Practice Address - Fax:410-763-6014
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR151146363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
9373824OtherNCPPO
DCW4320004OtherBLUE CHOICE
MD131282OtherPRIORITY PARTNERS
MD83107003OtherCAREFIRST