Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0106X | Oral and Maxillofacial Pathology | D1008614 | NJ |
N | 1223S0112X | Oral and Maxillofacial Surgeon | D1008614 | NJ |
NPI | 1053347096 |
---|---|
Provider Name | Dr. Steven Mark Baum |
First Address | Princeton, NJ 08540 |
Second Address | Newark, NJ 07103-2495 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T99485 | (02) |