Provider Demographics
NPI:1225049554
Name:BAIR, ROSALIE LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSALIE
Middle Name:LYNN
Last Name:BAIR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5800 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-5532
Mailing Address - Country:US
Mailing Address - Phone:301-654-9677
Mailing Address - Fax:
Practice Address - Street 1:5612 SHIELDS DR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-3532
Practice Address - Country:US
Practice Address - Phone:301-571-4334
Practice Address - Fax:301-571-4315
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0047816207W00000X, 207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
521951113OtherTAX ID
G15290Medicare UPIN
BA800472Medicare ID - Type Unspecified