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NPI Code Detail

MEDICARE: ROBERT BAUER

MEDICARE: ROBERT 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
1207Q00000XFamily Medicine PhysicianD0014168MD

General Provider Information

NPI Number : 1790703189
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT BAUER
Provider Business Mailing Address
First Line : 24035 THREE NOTCH RD
Second Line :
City : HOLLYWOOD
State : MD
Zip : 20636-4871
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 28170 OLD VILLAGE RD
Second Line :
City : MECHANICSVILLE
State : MD
Zip : 20659-4289
Country : US
Telephone Number : 301-884-4666
Fax Number : 301-884-5852
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 10/15/2007

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