Mark R Bauer, M.D.
Individual provider Active NPI Internal Medicine Physician · Watertown, MA
NPI 1487625307 · NPPES record last updated Jun 27, 2011
Key facts
- NPI
- 1487625307
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 42997 (MA)
- Practice address
- 485 Arsenal St
Internal Medicine
Watertown, MA 02472-5091 - Phone
- (617) 972-5200
- Fax
- (617) 972-5512
- NPI assigned
- Jan 30, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 42997 | MA | Yes |
Addresses
Primary practice location
485 Arsenal St
Internal Medicine
Watertown, MA 02472-5091
Mailing address
147 Milk St
Provider Enrollment - 9TH Floor
Boston, MA 02109-4806
Phone (617) 559-8374
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| J05941 | Other | MA | BLUE CROSS |
| 3015262 | Medicaid | MA | |
| 042997 | Other | MA | TUFTS |
| PM569 | Other | MA | HARVARD PILGRIM |
Other providers in Watertown, MA
- Scott Patrick Barry
- Lauren Samantha Basile
- Olivia Bass
- Leon B Bastajian
- Nisha Ann Basu
- Edward V. Bauman
- Bay State Urologists Inc
- Beaverbrook Step, Inc.
- Margaret Ann Beck
- Carol Becker
All providers in Watertown, MA · Internal Medicine Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.