Provider Demographics
NPI:1922261189
Name:BAUM PSYCHIATRIC, PLLC
Entity Type:Organization
Organization Name:BAUM PSYCHIATRIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHAN
Authorized Official - Middle Name:FREDRICK
Authorized Official - Last Name:BAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-732-2897
Mailing Address - Street 1:602 ORCHARD PL
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-8495
Mailing Address - Country:US
Mailing Address - Phone:919-732-2897
Mailing Address - Fax:
Practice Address - Street 1:241 SAINT MARYS RD
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-2521
Practice Address - Country:US
Practice Address - Phone:919-732-2897
Practice Address - Fax:919-241-3135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891205NMedicaid
NC1205NOtherBCBS OF NC