Provider Demographics
NPI:1770597502
Name:BAUM, TAD DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:TAD
Middle Name:DAVID
Last Name:BAUM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:50 MEMORIAL DRIVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453
Mailing Address - Country:US
Mailing Address - Phone:978-534-2426
Mailing Address - Fax:978-534-4711
Practice Address - Street 1:50 MEMORIAL DRIVE
Practice Address - Street 2:SUITE 105
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453
Practice Address - Country:US
Practice Address - Phone:978-534-2426
Practice Address - Fax:978-534-4711
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2015-12-28
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Provider Licenses
StateLicense IDTaxonomies
MA150333207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
043540266OtherFALLON
0800773OtherUNITED HEALTH CARE
151588OtherHARVARD PILGRIM
J16528OtherBLUE SHIELD
MA3150356Medicaid
043540266OtherONE HEALTH PLAN
043540266OtherTRICARE
043540266OtherUNICARE
3150356OtherMASS HEALTH
40918OtherDAVIS VISION
B20757203OtherCIGNA
043540266OtherPRIVATE HEALTH CARE
043540266OtherGIC
150333OtherTUFTS
2435111OtherAETNA
MA3150756Medicaid
977333OtherNETWORK HEALTH
043540266OtherTRICARE
043540266OtherUNICARE