MEDICARE: LESLIE GAYLE BAHR PHARM.D.

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	183500000X	Pharmacist	20359	MD

General Provider Information

NPI Number	:	1326316431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLIE GAYLE BAHR PHARM.D.

Provider Business Mailing Address
First Line	:	444 WMC DR STE 116
Second Line	:
City	:	WESTMINSTER
State	:	MD
Zip	:	21158-4337
Country	:	US
Telephone Number	:	410-871-1203
Fax Number	:

Provider Business Practice Location Address
First Line	:	444 WMC DR STE 116
Second Line	:
City	:	WESTMINSTER
State	:	MD
Zip	:	21158-4337
Country	:	US
Telephone Number	:	410-871-1203
Fax Number	:

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

Provider Enumeration Date	:	12/02/2011
Last Update Date	:	12/05/2011

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