Provider Demographics
NPI:1093830077
Name:MARC D BAER DPM LLC
Entity Type:Organization
Organization Name:MARC D BAER DPM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:D
Authorized Official - Last Name:BAER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:610-642-5040
Mailing Address - Street 1:600 HAVERFORD RD
Mailing Address - Street 2:SUITE G103
Mailing Address - City:HAVERFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19041-1139
Mailing Address - Country:US
Mailing Address - Phone:610-642-5040
Mailing Address - Fax:610-642-5042
Practice Address - Street 1:MEDICAL OFFICE BUILDING WEST
Practice Address - Street 2:SUITE 330
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096
Practice Address - Country:US
Practice Address - Phone:610-642-5040
Practice Address - Fax:610-642-5042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004682L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA083313Medicare ID - Type Unspecified
PAU90133Medicare UPIN