Provider Demographics
NPI:1093801813
Name:BAUMGARTNER, ROBERT JOHN (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:JOHN
Last Name:BAUMGARTNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1400 FOREST GLEN ROAD
Mailing Address - Street 2:SUITE 315
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910
Mailing Address - Country:US
Mailing Address - Phone:301-754-0085
Mailing Address - Fax:301-754-0082
Practice Address - Street 1:1400 FOREST GLEN ROAD
Practice Address - Street 2:SUITE 315
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910
Practice Address - Country:US
Practice Address - Phone:301-754-0085
Practice Address - Fax:301-754-0082
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD20407207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E53238Medicare UPIN
MD099235Medicare ID - Type Unspecified