MEDICARE: MRS. BARBARA SUE BAER BS EDUCATION

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	174400000X	Specialist

General Provider Information

NPI Number	:	1568504009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BARBARA SUE BAER BS EDUCATION

Provider Business Mailing Address
First Line	:	9370 OLD BONHOMME RD
Second Line	:
City	:	OLIVETTE
State	:	MO
Zip	:	63132-4328
Country	:	US
Telephone Number	:	314-993-2584
Fax Number	:

Provider Business Practice Location Address
First Line	:	641 N NEW BALLAS RD
Second Line	:
City	:	CREVE COEUR
State	:	MO
Zip	:	63141-6713
Country	:	US
Telephone Number	:	314-872-3345
Fax Number	:	314-872-3180

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

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	07/08/2007

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