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General NPI Number Information
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NPI Number | 1790166130
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Entity Type | Individual
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Provider Name | ERIC L BAUER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/11/2015
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Last Update Date | 06/02/2020
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Provider Practice Location Address
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Address Line | 1222 S PATTERSON BLVD STE 400
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City | DAYTON
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State | OH
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Zip | 45402-2642
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Country | US
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Telephone | 937-496-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 1222 S PATTERSON BLVD STE 400
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City | DAYTON
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State | OH
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Zip | 45402-2642
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Country | US
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Telephone | 937-496-2600
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 2015016477
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 35.138511
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License Number State | OH
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