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NPI Code Detail

MEDICARE: KENDRA JEAN BAUER MD

MEDICARE:   KENDRA JEAN BAUER  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician4301506539MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14351045080OTHERMILIMITED EDUCATION LICENSE
25315207186OTHERMICONTROLLED SUBSTANCE LICENSE

General Provider Information

NPI Number : 1083271522
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENDRA JEAN BAUER MD
Provider Business Mailing Address
First Line : 3621 S STATE ST
Second Line :
City : ANN ARBOR
State : MI
Zip : 48108-1633
Country : US
Telephone Number : 734-647-5299
Fax Number :
Provider Business Practice Location Address
First Line : 380 PARKLAND PLZ
Second Line :
City : ANN ARBOR
State : MI
Zip : 48103-6201
Country : US
Telephone Number : 734-539-5080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2019
Last Update Date : 12/12/2025

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Directions to “ KENDRA JEAN BAUER MD” Practice Location

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