Healthcare Provider Details

I. General information

NPI: 1417392986
Provider Name (Legal Business Name): CHEE YOON SHIM BAUER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2013
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CHILDRENS AVE STE 9A
OKLAHOMA CITY OK
73104-4637
US

IV. Provider business mailing address

940 NE 13TH ST
OKLAHOMA CITY OK
73104-5008
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-2234
  • Fax:
Mailing address:
  • Phone: 405-271-4417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number30054
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License Number30054
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number30054
License Number StateOK
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number30054
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: