Provider Demographics
NPI:1326133539
Name:BAIER, JOHN CLETUS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CLETUS
Last Name:BAIER
Suffix:JR
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 1:60 COMMERCIAL ST
Mailing Address - Street 2:SUITE 404
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5071
Mailing Address - Country:US
Mailing Address - Phone:603-226-2200
Mailing Address - Fax:
Practice Address - Street 1:60 COMMERCIAL ST
Practice Address - Street 2:SUITE 404
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5096
Practice Address - Country:US
Practice Address - Phone:603-228-1763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH7602207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30002468Medicaid
NHSX0207Medicare PIN
D78743Medicare UPIN