Provider Demographics
NPI:1942038393
Name:BAUMAN, PETER
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:BAUMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3928 NICHOLSON ST
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-3062
Mailing Address - Country:US
Mailing Address - Phone:770-265-2069
Mailing Address - Fax:
Practice Address - Street 1:1322 H ST NE UNIT B
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-7986
Practice Address - Country:US
Practice Address - Phone:703-829-7240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD310301041C0700X
DCLG2000028011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical