MEDICARE: VANGUARD MEDICAL SERVICES LLC

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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1417706250
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VANGUARD MEDICAL SERVICES LLC

Provider Business Mailing Address
First Line	:	700 HIGHLAND AVE
Second Line	:
City	:	SALEM
State	:	OH
Zip	:	44460-1808
Country	:	US
Telephone Number	:	210-722-7662
Fax Number	:

Provider Business Practice Location Address
First Line	:	657 E STATE ST
Second Line	:
City	:	SALEM
State	:	OH
Zip	:	44460-2958
Country	:	US
Telephone Number	:	210-722-7662
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. MARSHALL BAHR
Credential	:	MD, MBA
Telephone Number	:	210-722-7662

Provider Enumeration Date	:	05/14/2024
Last Update Date	:	05/14/2024

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Directions to “VANGUARD MEDICAL SERVICES LLC ” Practice Location

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