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General NPI Number Information
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NPI Number | 1114026101
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Entity Type | Individual
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Provider Name | KATHLEEN M BAUER MD
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Gender | Female
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 12/26/2007
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Provider Practice Location Address
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Address Line | 1215 E MICHIGAN AVE
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City | LANSING
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State | MI
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Zip | 48912-1811
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Country | US
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Telephone | 517-364-2223
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 634280
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City | CINCINNATI
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State | OH
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Zip | 45263-0041
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Country | US
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Telephone | 517-336-8080
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Fax | 517-336-9122
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 047513
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License Number State | MI
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