Provider Demographics
NPI:1336437045
Name:BAUM, ANTONIA L (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTONIA
Middle Name:L
Last Name:BAUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5522 WARWICK PL
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-5506
Mailing Address - Country:US
Mailing Address - Phone:301-656-9101
Mailing Address - Fax:
Practice Address - Street 1:5522 WARWICK PL
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-5506
Practice Address - Country:US
Practice Address - Phone:301-656-9101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD479082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry