Healthcare Provider Details

I. General information

NPI: 1750777538
Provider Name (Legal Business Name): JAMES AUSTIN BAER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2015
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UNIVERSITY DR
HERSHEY PA
17033-2360
US

IV. Provider business mailing address

4520 UNION DEPOSIT RD
HARRISBURG PA
17111-2910
US

V. Phone/Fax

Practice location:
  • Phone: 717-531-8903
  • Fax:
Mailing address:
  • Phone: 717-531-4094
  • Fax: 717-531-0136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD468965
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: