Healthcare Provider Details

I. General information

NPI: 1417913591
Provider Name (Legal Business Name): CHRISTOPHER EDWARD BAUR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 YORKTOWN DR STE 100
FAYETTEVILLE GA
30214-7663
US

IV. Provider business mailing address

101 YORKTOWN DR STE 100
FAYETTEVILLE GA
30214-7663
US

V. Phone/Fax

Practice location:
  • Phone: 770-460-4285
  • Fax: 770-460-4719
Mailing address:
  • Phone: 770-460-4285
  • Fax: 770-460-4719

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME0064882
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number98020
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: