Healthcare Provider Details

I. General information

NPI: 1437123254
Provider Name (Legal Business Name): CHRISTOPHER E BAUER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 03/07/2023
Certification Date: 11/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1027 BELLEVUE AVE SUITE 200
SAINT LOUIS MO
63117-1851
US

IV. Provider business mailing address

PO BOX 955534
SAINT LOUIS MO
63195-5534
US

V. Phone/Fax

Practice location:
  • Phone: 314-645-6450
  • Fax: 314-645-2560
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number47615
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25493
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number2011004442
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: