Individual
JANET K. BAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 SOUTH ST, SOUTHBRIDGE, MA 01550-4051
(508) 765-9771
Mailing address
100 SOUTH ST, SOUTHBRIDGE, MA 01550-4051
(508) 765-9771
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
71678
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
488616010
—
MI
01
—
700H262300
BLUE CROSS-BLUE CROSS
—
01
—
JB029306
CHAMPUS-CHAMPUS
—
Enumeration date
11/08/2005
Last updated
06/27/2013
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