Provider Demographics
NPI:1679553358
Name:BAER, ANNA B (MD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:B
Last Name:BAER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:KATHRYN
Other - Last Name:BLACKMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:650 PETER JEFFERSON PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8844
Mailing Address - Country:US
Mailing Address - Phone:434-293-4072
Mailing Address - Fax:434-293-4265
Practice Address - Street 1:650 PETER JEFFERSON PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8844
Practice Address - Country:US
Practice Address - Phone:434-293-4072
Practice Address - Fax:434-293-4265
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101237798207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA456179OtherSOUTHERN HEALTH
VA247332OtherANTHEM
VAC10061OtherMEDICARE GROUP PIN
VAP00384057OtherRAILROAD MEDICARE
VA1679553358Medicaid
VAP00467034Medicare PIN
VA00X294C01Medicare PIN
VA1679553358Medicaid
VAC10061OtherMEDICARE GROUP PIN