Healthcare Provider Details

I. General information

NPI: 1053056812
Provider Name (Legal Business Name): CAMILLE BAUER MASTERS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAMILLE TERESE BAUER

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15110 JOHN J DELANEY DR STE 100
CHARLOTTE NC
28277-3545
US

IV. Provider business mailing address

15110 JOHN J DELANEY DR STE 100
CHARLOTTE NC
28277-3545
US

V. Phone/Fax

Practice location:
  • Phone: 704-512-5100
  • Fax: 615-343-8806
Mailing address:
  • Phone: 704-512-5100
  • Fax: 615-343-8806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2026-01270
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: