Provider Demographics
NPI:1861555997
Name:BAUM, MEREDITH M (RD)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:M
Last Name:BAUM
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:M
Other - Last Name:OTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:912 N 33RD ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-3404
Mailing Address - Country:US
Mailing Address - Phone:610-366-1988
Mailing Address - Fax:
Practice Address - Street 1:1200 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6202
Practice Address - Country:US
Practice Address - Phone:610-402-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA064463R8GMedicare ID - Type Unspecified