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Provider Information for 1831154111

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Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. DONALD S BAE MD

Gender: MALE

Individual NPI: 1831154111

Calendar   Last Updated:  2012-10-10
  Certification Date: 

Details

Name Value
NPI 1831154111
Enumeration Date 2006-04-19
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 300 LONGWOOD AVE HUNNEWELL 2
BOSTON, MA 02115-5724
United States

Phone: 617-355-6808 | Fax: 617-730-0459
View Map External Link
Primary Practice Address 300 LONGWOOD AVE
BOSTON, MA 02115-5724
United States

Phone: 617-355-6808 | Fax: 617-730-0459
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID MA 2004054
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207XP3100X - Orthopaedic Surgery Pediatric Orthopaedic Surgery MA 207071
No 207X00000X - Orthopaedic Surgery MA 207071
No 207XS0106X - Orthopaedic Surgery Hand Surgery MA 207071