Provider Demographics
NPI:1578311007
Name:BAUMGART, SAMANTHA (CBD)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:BAUMGART
Suffix:
Gender:F
Credentials:CBD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14141-1419
Mailing Address - Country:US
Mailing Address - Phone:716-341-9169
Mailing Address - Fax:
Practice Address - Street 1:253 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:14141-1419
Practice Address - Country:US
Practice Address - Phone:716-341-9169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula