Healthcare Provider Details

I. General information

NPI: 1962310250
Provider Name (Legal Business Name): WILLIAM BATHAUER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 100236 BOX 216
FPO AE
09532-3602
US

IV. Provider business mailing address

UNIT 100236 BOX 216
FPO AE
09532-3602
US

V. Phone/Fax

Practice location:
  • Phone: 757-967-3227
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: