MEDICARE: MICHAEL BRIAN BAUER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	9900164	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1227Y	OTHER	NC	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497799977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL BRIAN BAUER M.D.

Provider Business Mailing Address
First Line	:	730 MALCOLM BLVD STE 100
Second Line	:
City	:	CONNELLY SPRINGS
State	:	NC
Zip	:	28612-8079
Country	:	US
Telephone Number	:	828-580-7962
Fax Number	:	828-580-3392

Provider Business Practice Location Address
First Line	:	730 MALCOLM BLVD STE 100
Second Line	:
City	:	CONNELLY SPRINGS
State	:	NC
Zip	:	28612-8079
Country	:	US
Telephone Number	:	828-580-7962
Fax Number	:	828-580-3392

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	03/17/2018

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