Provider Demographics
NPI:1821072604
Name:BAYER, DEBORAH D (DO)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:D
Last Name:BAYER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1401 ATLANTIC AVE
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:ATLANTIC CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08401-7022
Mailing Address - Country:US
Mailing Address - Phone:609-441-2104
Mailing Address - Fax:609-441-2140
Practice Address - Street 1:1401 ATLANTIC AVE
Practice Address - Street 2:SUITE 2200
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-7022
Practice Address - Country:US
Practice Address - Phone:609-441-2104
Practice Address - Fax:609-441-2140
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB05525400207RH0002X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6194401Medicaid
028032Medicare ID - Type Unspecified
NJ6194401Medicaid