Provider Demographics
NPI:1801862990
Name:BAER, ROBERT W (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:W
Last Name:BAER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 2ND AVE E
Mailing Address - Street 2:SUITE B
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601-5218
Mailing Address - Country:US
Mailing Address - Phone:701-483-9720
Mailing Address - Fax:701-483-9721
Practice Address - Street 1:11 2ND AVE E
Practice Address - Street 2:SUITE B
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-5218
Practice Address - Country:US
Practice Address - Phone:701-483-9720
Practice Address - Fax:701-483-9721
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ND386103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND13948Medicaid
ND26664OtherBLUE CROSS BLUE SHIELD
ND13948Medicaid