Provider Demographics
NPI:1467453654
Name:BAER, THOMAS D (DPM)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:D
Last Name:BAER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 BROOKS LN
Mailing Address - Street 2:SUITE 160
Mailing Address - City:CLAIRTON
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3747
Mailing Address - Country:US
Mailing Address - Phone:412-405-8065
Mailing Address - Fax:412-405-8067
Practice Address - Street 1:1200 BROOKS LN
Practice Address - Street 2:SUITE 160
Practice Address - City:CLAIRTON
Practice Address - State:PA
Practice Address - Zip Code:15025
Practice Address - Country:US
Practice Address - Phone:412-405-8065
Practice Address - Fax:412-405-8067
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2467213E00000X
PASC-003461-R213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA608917OtherHIGHMARK BLUE SHIELD
PA1260327Medicaid
PA608917OtherHIGHMARK BLUE SHIELD
PA608917Medicare ID - Type Unspecified