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NPI Code Detail

MEDICARE: DR. WENDY L BAUER M.D.

MEDICARE: DR. WENDY L BAUER M.D.
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
1207V00000XObstetrics & Gynecology PhysicianWB061276MI

General Provider Information

NPI Number : 1164417416
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WENDY L BAUER M.D.
Provider Business Mailing Address
First Line : 2854 S 11TH ST
Second Line :
City : KALAMAZOO
State : MI
Zip : 49009-2129
Country : US
Telephone Number : 269-345-6197
Fax Number : 269-345-9734
Provider Business Practice Location Address
First Line : 2854 S 11TH ST
Second Line :
City : KALAMAZOO
State : MI
Zip : 49009-2129
Country : US
Telephone Number : 269-345-6197
Fax Number : 269-345-9734
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2005
Last Update Date : 02/01/2022

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