Basic Information
| Provider Information | |||||||||
| NPI: | 1518123231 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAUMANN | ||||||||
| FirstName: | MARLENE | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 N ACADEMY AVE | ||||||||
| Address2: | |||||||||
| City: | DANVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178224903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702716144 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 100 N ACADEMY AVE | ||||||||
| Address2: | |||||||||
| City: | DANVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178222342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702716144 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2008 | ||||||||
| LastUpdateDate: | 11/01/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085N0700X | 55905 | KY | N | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | 2085N0700X | TP315 | KY | N | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | 2085R0202X | MD446777 | PA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 390200000X | 35.087463 | OH | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2085N0700X | MD446777 | PA | Y | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology |
No ID Information.