MEDICARE: DR. BRANT ALLEN BAIR 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	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	2001-10	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871512152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRANT ALLEN BAIR MD

Provider Business Mailing Address
First Line	:	2100 CALLE DE LA VUELTA
Second Line	:	SUITE C103
City	:	SANTA FE
State	:	NM
Zip	:	87505-4742
Country	:	US
Telephone Number	:	505-982-5014
Fax Number	:	505-982-2687

Provider Business Practice Location Address
First Line	:	2100 CALLE DE LA VUELTA
Second Line	:	SUITE C103
City	:	SANTA FE
State	:	NM
Zip	:	87505-4742
Country	:	US
Telephone Number	:	505-982-5014
Fax Number	:	505-982-2687

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

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	04/20/2015

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Directions to “ DR. BRANT ALLEN BAIR MD” Practice Location

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