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NPI Code Detail

MEDICARE: MERRITT LEIGH BAUMGARTNER PA-C

MEDICARE:   MERRITT LEIGH BAUMGARTNER  PA-C
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
1363A00000XPhysician AssistantC0005993MD
2363A00000XPhysician Assistant0110003564VA

General Provider Information

NPI Number : 1538319041
Entity Type Code : Individual
Provider Name (Legal Business Name) : MERRITT LEIGH BAUMGARTNER PA-C
Provider Business Mailing Address
First Line : 1773 TYRONE ST
Second Line :
City : CROFTON
State : MD
Zip : 21114-2521
Country : US
Telephone Number : 901-827-8902
Fax Number :
Provider Business Practice Location Address
First Line : 1071 MD RT 3 N
Second Line :
City : GAMBRILLS
State : MD
Zip : 21054-1784
Country : US
Telephone Number : 410-721-2333
Fax Number : 410-721-1207
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2008
Last Update Date : 04/18/2017

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Directions to “ MERRITT LEIGH BAUMGARTNER PA-C” Practice Location

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