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NPI Code Detail

MEDICARE: MR. DAVID L BAUER MA

MEDICARE: MR. DAVID L BAUER MA
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
1101YM0800XMental Health Counselor39000884AIN

General Provider Information

NPI Number : 1265590665
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID L BAUER MA
Provider Business Mailing Address
First Line : 2505 VALLEY DR
Second Line :
City : VALPARAISO
State : IN
Zip : 46383-2518
Country : US
Telephone Number : 219-477-5646
Fax Number : 219-462-1579
Provider Business Practice Location Address
First Line : 2505 VALLEY DR
Second Line :
City : VALPARAISO
State : IN
Zip : 46383-2518
Country : US
Telephone Number : 219-477-5646
Fax Number : 219-462-1579
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2006
Last Update Date : 07/08/2007

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