Provider Demographics
NPI:1689729303
Name:BAUMAN & STOLERU, M.D., P.C.
Entity Type:Organization
Organization Name:BAUMAN & STOLERU, M.D., P.C.
Other - Org Name:BAUMAN AND STOLERU MDPC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRENZIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-387-8900
Mailing Address - Street 1:3553 16TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-3041
Mailing Address - Country:US
Mailing Address - Phone:202-387-8900
Mailing Address - Fax:202-328-0565
Practice Address - Street 1:3553 16TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3041
Practice Address - Country:US
Practice Address - Phone:202-387-8900
Practice Address - Fax:202-328-0565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC022453100Medicaid
DC022453400Medicaid
=========OtherTAX-IID
DC0416090001Medicare NSC