Provider Demographics
NPI:1841217288
Name:BEARER, CYNTHIA F (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:F
Last Name:BEARER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 62063
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-2063
Mailing Address - Country:US
Mailing Address - Phone:410-706-5181
Mailing Address - Fax:410-706-5103
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-6749
Practice Address - Fax:410-328-6136
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0638552080N0001X, 207L00000X
MDD682442080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019159920001OtherPA MEDICAID
OH000000525879OtherANTHEM
OH0639404OtherAETNA
OH363348OtherWELLCARE
OH745883OtherBUCKEYE
OH000000028053OtherANTHEM
OH0964649OtherBCMH
OH0964649Medicaid
OH000000221071OtherUNISON
MD415933100Medicaid
OHP00412282OtherRAILROAD MEDICARE
OHBE4177401Medicare PIN
OH000000525879OtherANTHEM
OH0639404OtherAETNA
OH0964649Medicaid