Provider Demographics
NPI:1699896829
Name:BAUERMEISTER, MARTIN H (MD)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:H
Last Name:BAUERMEISTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 BAY ST
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-5001
Mailing Address - Country:US
Mailing Address - Phone:401-295-0370
Mailing Address - Fax:
Practice Address - Street 1:17 BAY ST
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-5001
Practice Address - Country:US
Practice Address - Phone:401-295-0370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA366122084P0800X
RIMD053042084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry