Healthcare Provider Details

I. General information

NPI: 1316879265
Provider Name (Legal Business Name): EVAN WILLIAM BAER DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5716 CLEVELAND ST STE 200
VIRGINIA BEACH VA
23462-1784
US

IV. Provider business mailing address

3317 REGENT PARK WALK
VIRGINIA BEACH VA
23452-6257
US

V. Phone/Fax

Practice location:
  • Phone: 757-490-4802
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305217761
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: