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General NPI Number Information
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NPI Number | 1588234066
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Entity Type | Organization
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Legal Business Name | DR. BAUER-OLSON, FAMILY DOCTOR, PLLC
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Dates
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Enumeration Date | 06/28/2021
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Last Update Date | 05/15/2023
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Provider Practice Location Address
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Address Line | 4133 30TH AVE S STE 103
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City | FARGO
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State | ND
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Zip | 58104-8421
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Country | US
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Telephone | 701-499-4847
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Fax | 701-433-1882
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Provider Business Mailing Address
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Address Line | 2413 E COUNTRY CLUB DR S
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City | FARGO
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State | ND
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Zip | 58103-5730
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Country | US
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Telephone | 701-429-4385
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHERYL K BAUER-OLSON
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Credential | DO
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Telephone | 701-499-4847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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