Provider Demographics
NPI:1285686287
Name:BAER, ALEXANDER B (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:B
Last Name:BAER
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 1:1147 REDFIELDS RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-7889
Mailing Address - Country:US
Mailing Address - Phone:434-975-4934
Mailing Address - Fax:434-975-4934
Practice Address - Street 1:235 CANTRELL AVE
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3248
Practice Address - Country:US
Practice Address - Phone:540-564-7378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232099207P00000X, 207PT0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PT0002XAllopathic & Osteopathic PhysiciansEmergency MedicineMedical Toxicology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010063051Medicaid
VAP00148424OtherRAILROAD MEDICARE
VA1841476000OtherWEST VA MEDICAID
VA010047854Medicaid
VA010047854Medicaid
VA004220H12Medicare PIN
VAH60550Medicare UPIN
VA010063051Medicaid