Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | MD.26343 | AL |
NPI | 1063544062 |
---|---|
Provider Name | Dr. Stephanie Leigh Baer |
First Address | Augusta, GA 30904-6258 |
Second Address | Augusta, GA 30904-6258 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2007 |
Last Update Date | 18/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
741681225A | (05) | GA |
G61392 | (05) | SC |