Provider Demographics
NPI:1306801964
Name:BAUMANN, HERMAN A (MD)
Entity type:Individual
Prefix:
First Name:HERMAN
Middle Name:A
Last Name:BAUMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HAL
Other - Middle Name:A
Other - Last Name:BAUMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:1930 BISHOP LN
Practice Address - Street 2:STE 1600
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-1929
Practice Address - Country:US
Practice Address - Phone:502-272-5044
Practice Address - Fax:502-272-5121
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY23255207R00000X
IN01033465A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN110138275OtherRAILROAD MEDICARE
00000050932OtherANTHEM - NCMA
IN100086530Medicaid
KYP00357999OtherRAILROAD MEDICARE
KY000000724438OtherANTHEM - NHC
KY127314OtherSIHO - NHC
KY64232556Medicaid
004187OtherSIHO - NCMA
KY50035904OtherPASSPORT - NHC
KY000000724438OtherANTHEM - NHC
IN110138275OtherRAILROAD MEDICARE
KYP00357999OtherRAILROAD MEDICARE
KY64232556Medicaid