MEDICARE: MELANIE JO BAUER

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
1	171M00000X	Case Manager/Care Coordinator

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629304092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE JO BAUER

Provider Business Mailing Address
First Line	:	1801 E DOWLING RD
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99507-1918
Country	:	US
Telephone Number	:	907-569-7135
Fax Number	:	907-868-4658

Provider Business Practice Location Address
First Line	:	1801 E DOWLING RD
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99507-1918
Country	:	US
Telephone Number	:	907-569-7135
Fax Number	:	907-868-4658

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2009
Last Update Date	:	10/20/2009

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Directions to “ MELANIE JO BAUER ” Practice Location

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