Individual
DR. MICHELLE A BAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6129
(617) 730-0569
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
77307
MA
2080P0210X
Pediatric Nephrology Physician
Primary
77307
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3153290
—
MA
Enumeration date
01/30/2006
Last updated
04/28/2014
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