Bauer, Mark R

Bauer, Mark R is an individual health care provider with primary practice located at 485 Arsenal St Internal Medicine, Watertown MA 02472-5091. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Bauer, Mark R can be contacted via phone (617) 972-5200.

Contact Information

Primary practice address
485 Arsenal St Internal Medicine Watertown MA 02472-5091
Phone: (617) 972-5200
Fax: (617) 972-5512
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 42997 Massachusetts

Profile Details

NPI number 1487625307
LBN Legal business name Bauer, Mark R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2006
Last updated Jun 27th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487625307 NPPES
Massachusetts Other J05941 BLUE CROSS
Massachusetts MEDICAID 3015262 BLUE CROSS
Massachusetts Other 042997 BLUE CROSS
Massachusetts Other PM569 BLUE CROSS

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