MEDICARE: KAREN BAUER

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
1	207Q00000X	Family Medicine Physician	D0062042	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205854684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN BAUER

Provider Business Mailing Address
First Line	:	28030 OLD VILLAGE RD
Second Line	:
City	:	MECHANICSVILLE
State	:	MD
Zip	:	20659-4288
Country	:	US
Telephone Number	:	301-373-7900
Fax Number	:	301-373-6900

Provider Business Practice Location Address
First Line	:	28030 OLD VILLAGE RD
Second Line	:
City	:	MECHANICSVILLE
State	:	MD
Zip	:	20659-4288
Country	:	US
Telephone Number	:	301-373-7900
Fax Number	:	301-373-6900

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	12/13/2021

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Directions to “ KAREN BAUER ” Practice Location

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