Provider Demographics
NPI:1346207446
Name:BAUM, ROBERT J (PA)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:BAUM
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:988102 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-8102
Mailing Address - Country:US
Mailing Address - Phone:402-559-9800
Mailing Address - Fax:402-559-5080
Practice Address - Street 1:988102 NEBRASKA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-8102
Practice Address - Country:US
Practice Address - Phone:402-559-9800
Practice Address - Fax:402-559-5080
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2011-06-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE843363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE271369Medicare ID - Type Unspecified
NES71096Medicare UPIN