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NPI Code Detail

MEDICARE: PAUL H BAEHR M.D.

MEDICARE: PAUL H BAEHR M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology PhysicianM-6693ID

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00092851OTHERIDRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2000010002838OTHERIDBLUE SHIELD OF IDAHO
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4286271OTHERIDOREGON HEALTH AND WELFARE
533068OTHERIDBLUE CROSS OF IDAHO

General Provider Information

NPI Number : 1184619165
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL H BAEHR M.D.
Provider Business Mailing Address
First Line : 425 W BANNOCK ST
Second Line :
City : BOISE
State : ID
Zip : 83702-6035
Country : US
Telephone Number : 208-343-1702
Fax Number : 208-342-7042
Provider Business Practice Location Address
First Line : 425 W BANNOCK ST
Second Line :
City : BOISE
State : ID
Zip : 83702-6035
Country : US
Telephone Number : 208-343-1702
Fax Number : 208-342-7042
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2005
Last Update Date : 10/14/2016

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Directions to “ PAUL H BAEHR M.D.” Practice Location

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