Michael David Baum
Individual provider Active NPI Driver · Charles Town, WV
NPI 1861968117 · NPPES record last updated Oct 14, 2018
Key facts
- NPI
- 1861968117
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- F901576 (WV)
- Practice address
- 41 New Thomas Dr
Charles Town, WV 25414-4822 - Phone
- (304) 270-8110
- NPI assigned
- Oct 14, 2018
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F901576 | WV | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | F901576 | WV | Yes |
Addresses
Primary practice location
41 New Thomas Dr
Charles Town, WV 25414-4822
Mailing address
41 New Thomas Dr
Charles Town, WV 25414-4822
Phone (304) 270-8110
Other providers in Charles Town, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.