Individual
JEANNE ANNE BAUMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
104 E 2ND ST, 5TH FLOOR, ERIE, PA 16507-1532
(814) 877-5560
(814) 877-5561
Mailing address
104 E 2ND ST, 5TH FLOOR, ERIE, PA 16507-1532
(814) 877-5560
(814) 877-5561
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD031200E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00025609603
UNIVERA
NY
05
—
0012309900008
—
PA
01
—
01613478
NY MEDICAL ASSISTANCE
NY
01
—
0950163
OH MEDICAL ASSISTANCE
OH
01
—
1536528
GATEWAY
PA
01
—
220272
UPMC
PA
01
—
3000453
W. VIRGINIA WORKERS COMP
WV
01
—
300104963
RR MEDICARE
PA
01
—
603189
BLUE SHIELD
PA
01
—
88936
UNISON
PA
Enumeration date
01/23/2006
Last updated
07/23/2019
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