Healthcare Provider Details

I. General information

NPI: 1225049554
Provider Name (Legal Business Name): ROSALIE LYNN BAIR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5612 SHIELDS DR
BETHESDA MD
20817-3532
US

IV. Provider business mailing address

5612 SHIELDS DR
BETHESDA MD
20817-3532
US

V. Phone/Fax

Practice location:
  • Phone: 301-896-0890
  • Fax:
Mailing address:
  • Phone: 301-571-4334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberD0047816
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License NumberD0047816
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: