Provider Demographics
NPI:1952375529
Name:BAVER, JAIME L (PA-C)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:L
Last Name:BAVER
Suffix:
Gender:F
Credentials:PA-C
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 13579
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19612-3579
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1040 REED AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-2029
Practice Address - Country:US
Practice Address - Phone:610-898-7560
Practice Address - Fax:610-898-7561
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA003018L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA062122Medicare ID - Type Unspecified
P26071Medicare UPIN