Individual
DR. STEVEN KEITH BAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3620 WYOMING BLVD NE STE 112, ALBUQUERQUE, NM 87111-3288
(505) 918-2750
(505) 214-5897
Mailing address
3620 WYOMING BLVD NE STE 112, ALBUQUERQUE, NM 87111-3288
(505) 918-2750
(505) 508-5438
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0949NEWMEXICO
NM
103T00000X
Psychologist
MI 5686
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02886006
—
NM
01
—
11271575
CAQH
NM
01
—
NMA100027
MEDICARE PTAN
NM
01
—
P00960461
RAIL ROAD MEDICARE
NM
Enumeration date
09/01/2006
Last updated
12/08/2019
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