Provider Demographics
NPI:1093196149
Name:ANTONIO V BAUTE, MD, LLC
Entity Type:Organization
Organization Name:ANTONIO V BAUTE, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:V
Authorized Official - Last Name:BAUTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-617-9649
Mailing Address - Street 1:40 FOX CHASE
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-2491
Mailing Address - Country:US
Mailing Address - Phone:352-617-9649
Mailing Address - Fax:
Practice Address - Street 1:40 FOX CHASE
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-2491
Practice Address - Country:US
Practice Address - Phone:770-500-7162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-15
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA19142207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty