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General NPI Number Information
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NPI Number | 1881022358
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Entity Type | Organization
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Legal Business Name | BAUER MEDICAL GROUP
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Dates
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Enumeration Date | 10/21/2013
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Last Update Date | 10/21/2013
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Provider Practice Location Address
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Address Line | 6564 SE LAKE RD SUITE 101
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City | MILWAUKIE
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State | OR
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Zip | 97222-2237
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Country | US
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Telephone | 503-236-2303
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Fax | 503-236-2614
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Provider Business Mailing Address
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Address Line | 6564 SE LAKE RD SUITE 101
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City | MILWAUKIE
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State | OR
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Zip | 97222-2237
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Country | US
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Telephone | 503-236-2303
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Fax | 503-236-2614
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MISTY CAMPBELL
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Credential |
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Telephone | 503-236-2303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 01994
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO162206
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License Number State | OR
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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 | DO154162
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License Number State | OR
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