Provider Demographics
NPI:1225033665
Name:BAUER, THOMAS L (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:L
Last Name:BAUER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-741-8170
Mailing Address - Fax:717-741-8217
Practice Address - Street 1:1575 BANNISTER ST
Practice Address - Street 2:SUITE 7
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404-4946
Practice Address - Country:US
Practice Address - Phone:717-741-8170
Practice Address - Fax:717-741-8217
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD008690E208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA033227OtherJOHNS HOPKINS
PA578713OtherHIGHMARK BLUE SHIELD
PA000633908Medicaid
PA1514989OtherGATEWAY-WMG
PA261030OtherUNISON-WMG
PA548797OtherCAREFIRST MD BCBS
PA20082424OtherAMERIHEALTH MERCY-WMG
PA50083177OtherCAPITAL BLUE CROSS-WMG
PAP00719131Medicare PIN
PA50083177OtherCAPITAL BLUE CROSS-WMG
PAB33321Medicare UPIN