Provider Demographics
NPI:1295710085
Name:BAUMRUCKER, JOHN F (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:BAUMRUCKER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:209 HOSPITAL DR
Mailing Address - Street 2:SUITE #304
Mailing Address - City:HIGHLANDS
Mailing Address - State:NC
Mailing Address - Zip Code:28741-7623
Mailing Address - Country:US
Mailing Address - Phone:828-526-1700
Mailing Address - Fax:828-787-2451
Practice Address - Street 1:209 HOSPITAL DR
Practice Address - Street 2:SUITE #304
Practice Address - City:HIGHLANDS
Practice Address - State:NC
Practice Address - Zip Code:28741-7623
Practice Address - Country:US
Practice Address - Phone:828-526-1700
Practice Address - Fax:828-787-2451
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2009-06-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC17200174400000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC13945Medicaid
NCC80614Medicare UPIN
NC201336Medicare PIN