Individual
DR. JEREMY MICHAEL BAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11111 S 84TH ST, SUITE 2476, PAPILLION, NE 68046-4122
(402) 339-8974
(402) 339-6741
Mailing address
10144 EDWARD ST, LA VISTA, NE 68128-2500
(402) 614-3452
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
245480-1
NY
2085R0202X
Diagnostic Radiology Physician
Primary
24581
NE
2085R0202X
Diagnostic Radiology Physician
37694
IA
Other
Enumeration date
02/18/2008
Last updated
12/15/2010
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