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General NPI Number Information
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NPI Number | 1952519043
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Entity Type | Individual
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Provider Name | JENNIFER DAWN BAHNER M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/20/2007
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 29111 CEDAR RD
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City | MAYFIELD HEIGHTS
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State | OH
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Zip | 44124-4005
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Country | US
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Telephone | 440-646-1600
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Fax | 440-646-1505
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Provider Business Mailing Address
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Address Line | 2000 AUBURN DR STE 350
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City | BEACHWOOD
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State | OH
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Zip | 44122-4327
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Country | US
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Telephone | 440-646-1600
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Fax | 440-646-1500
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 57-012117
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 35.123019
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 57.012117
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | 57-012117
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License Number State | OH
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