MEDICARE: MARTIN H BAUERMEISTER M.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	2084P0800X	Psychiatry Physician	36612	MA
2	2084P0800X	Psychiatry Physician	MD05304	RI

General Provider Information

NPI Number	:	1699896829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTIN H BAUERMEISTER M.D.

Provider Business Mailing Address
First Line	:	17 BAY ST
Second Line	:
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-5001
Country	:	US
Telephone Number	:	401-295-0370
Fax Number	:

Provider Business Practice Location Address
First Line	:	17 BAY ST
Second Line	:
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-5001
Country	:	US
Telephone Number	:	401-295-0370
Fax Number	:

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

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	03/08/2026

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