Gary G Bawtinhimer, M.D.

Individual provider Active NPI Psychiatry Physician · Ayden, NC

NPI 1699772103 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1699772103
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatry Physician 2084P0800X
Practice address
3675 Rountree Rd
Ayden, NC 28513-8749
Phone
(252) 414-9072
Fax
(252) 439-0269
NPI assigned
Jun 30, 2005
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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

State licenses

LicenseStateTypeSpecialty
000023997NCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albemarle Mental Health Center Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NC Yes

Addresses

Primary practice location

3675 Rountree Rd
Ayden, NC 28513-8749

Mailing address

3675 Rountree Rd
Ayden, NC 28513-8749
Phone (252) 414-9072

Other identifiers

IdentifierTypeStateIssuer
13941OtherNCBCBS NC
8913941MedicaidNC

Other providers in Ayden, NC

All providers in Ayden, NC · Psychiatry Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.