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General NPI Number Information
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NPI Number | 1780838789
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Entity Type | Individual
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Provider Name | NISHA RAY BAUR DO
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Gender | Female
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Dates
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Enumeration Date | 11/05/2008
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | UNIT 3215 BOX RAMSTEIN
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City | APO
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State | AE
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Zip | 09094-3215
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Country | US
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Telephone | 314-479-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 7612 S 2800 E
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City | SOUTH WEBER
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State | UT
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Zip | 84405-9627
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Country | US
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Telephone | 801-920-3918
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 7152185-1204
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | FB1143647
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 7152185-1204
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 2083A0100X
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Taxonomy Name | Aerospace Medicine Physician
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License Number | 7152185-1204
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License Number State | UT
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