Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 36.002732 | OH |
N | 222Z00000X | Podiatrist | 36.002732 | OH |
Y | 213EP1101X | Primary Podiatric Medicine | 36.002732 | OH |
N | 213ES0103X | Foot & Ankle Surgery | 36.002732 | OH |
NPI | 1093710808 |
---|---|
Provider Name | David Nicholas Baer |
First Address | North Lima, OH 44452-8702 |
Second Address | Columbiana, OH 44408 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2005 |
Last Update Date | 18/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0855669 | (05) | OH |