Individual
KEVIN ANTHONY BAUMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4700 MEMORIAL DR, STE 340, BELLEVILLE, IL 62226-5373
(618) 234-9884
(618) 235-9020
Mailing address
4700 MEMORIAL DR, STE 340, BELLEVILLE, IL 62226-5373
(618) 234-9884
(618) 235-9020
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036090101
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036090101
—
IL
05
—
1891799565
—
IL
Enumeration date
06/09/2005
Last updated
02/05/2021
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