Doctor Name: | JOAN BAUMBACH |
NPI Number: | 1790045839 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 96-191 |
Business Practice Address: | 1190 S Saint Francis Dr N1350 Santa Fe, NM - 875054173 |
Business Phone Number: | 5058270011 |
Business Fax Number: | 5058270013 |
Mailing Address: | 1190 S Saint Francis Dr, N1350 SANTA FE |
State: | NM |
Postal Code: | 875054173 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/23/2012 |
NPI Last Update Date: | 05/23/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 96-191 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |