MEDICARE: LEE MATTHEW BAUTER MD

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	207Y00000X	Otolaryngology Physician	MD30596	ME

General Provider Information

NPI Number	:	1114506615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEE MATTHEW BAUTER MD

Provider Business Mailing Address
First Line	:	81 MEDICAL CENTER DR STE 2400
Second Line	:
City	:	BRUNSWICK
State	:	ME
Zip	:	04011-2764
Country	:	US
Telephone Number	:	207-721-0911
Fax Number	:	207-618-5691

Provider Business Practice Location Address
First Line	:	81 MEDICAL CENTER DR STE 2400
Second Line	:
City	:	BRUNSWICK
State	:	ME
Zip	:	04011-2764
Country	:	US
Telephone Number	:	207-721-0911
Fax Number	:	207-618-5691

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

Provider Enumeration Date	:	04/03/2021
Last Update Date	:	06/25/2026

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