MEDICARE: DR. DEVIN VINCENT BAER OD

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	152W00000X	Optometrist	OPT-002276	AZ

General Provider Information

NPI Number	:	1306332580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEVIN VINCENT BAER OD

Provider Business Mailing Address
First Line	:	2636 E HARRISON CT
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85295-9030
Country	:	US
Telephone Number	:	480-250-5475
Fax Number	:

Provider Business Practice Location Address
First Line	:	1155 S POWER RD STE 102
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-3716
Country	:	US
Telephone Number	:	480-214-0011
Fax Number	:

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

Provider Enumeration Date	:	07/10/2018
Last Update Date	:	07/10/2018

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