Individual
PHILLIP ADAM BAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 N MAPLEMERE RD STE 120, WILLIAMSVILLE, NY 14221-3178
(716) 836-4646
(716) 836-4696
Mailing address
111 N MAPLEMERE RD STE 120, WILLIAMSVILLE, NY 14221-3178
(716) 836-4646
(716) 836-4696
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
238732
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00028079102
UNIVERA
—
01
—
000529146001
BLUE SHIELD WNY
—
05
—
02863569
—
NY
01
—
160447
GHI
—
01
—
160448
GHI
—
01
—
1614085
INDEPENDENT HEALTH
—
01
—
205805FF
PREFERRED CARE
—
01
—
71105000049
FIDELIS
—
01
—
P010238732
BLUE CHOICE
—
01
—
P020238732
BLUE SHIELD ROCHESTER
—
Enumeration date
07/13/2005
Last updated
08/18/2023
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