Provider Demographics
NPI:1548204795
Name:BAUM, KARYN (MD)
Entity type:Individual
Prefix:
First Name:KARYN
Middle Name:
Last Name:BAUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454-1450
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2450 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1450
Practice Address - Country:US
Practice Address - Phone:612-273-3000
Practice Address - Fax:612-273-4370
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN39729207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP28873OtherHEALTHPARTNERS
MN04-00123OtherMEDICA PRIMARY
WI32410300Medicaid
MN04-08444OtherMEDICA CHOICE
MN796309OtherARAZ
MN07G84BAOtherBCBS
MN731518000Medicaid
MN1016610OtherPREFERRED ONE
IA0505487Medicaid
MN122653OtherUCARE
MN04-00123OtherMEDICA PRIMARY
MN110005136Medicare ID - Type UnspecifiedMN MEDICARE