Provider Demographics
NPI:1467408187
Name:DANIEL BAER DO PC
Entity Type:Organization
Organization Name:DANIEL BAER DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:BAER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:719-219-2350
Mailing Address - Street 1:PO BOX 5182
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-5182
Mailing Address - Country:US
Mailing Address - Phone:800-968-6866
Mailing Address - Fax:616-532-7230
Practice Address - Street 1:2020 N ACADEMY BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1567
Practice Address - Country:US
Practice Address - Phone:719-219-2350
Practice Address - Fax:719-219-0916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO405242081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODA677159OtherBCBS
CO38859831Medicaid
CO80909A002OtherCHAMPUS
CODA677159OtherBCBS
CO80909A002OtherCHAMPUS
CO38859831Medicaid