Provider Demographics
NPI:1972700631
Name:DR. ROBERT C. BAUMAN, PLLC
Entity Type:Organization
Organization Name:DR. ROBERT C. BAUMAN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:BAUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:802-522-3209
Mailing Address - Street 1:166 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STOWE
Mailing Address - State:VT
Mailing Address - Zip Code:05672
Mailing Address - Country:US
Mailing Address - Phone:802-253-6322
Mailing Address - Fax:802-253-0842
Practice Address - Street 1:166 S MAIN ST
Practice Address - Street 2:
Practice Address - City:STOWE
Practice Address - State:VT
Practice Address - Zip Code:05672
Practice Address - Country:US
Practice Address - Phone:802-253-6322
Practice Address - Fax:802-253-0842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty