Provider Demographics
NPI:1366591778
Name:BAUMAN, JOEL A (MD)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:A
Last Name:BAUMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:85 SEYMOUR ST
Mailing Address - Street 2:SUITE 709
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-5501
Mailing Address - Country:US
Mailing Address - Phone:860-696-2290
Mailing Address - Fax:860-696-2280
Practice Address - Street 1:85 SEYMOUR ST
Practice Address - Street 2:SUITE 709
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5501
Practice Address - Country:US
Practice Address - Phone:860-696-2290
Practice Address - Fax:860-696-2280
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2014-09-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT51554207T00000X
MA250612207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1366591778Medicaid
CTD400153873Medicare PIN