MEDICARE: ALLAN W BACH 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
1	207XS0106X	Orthopaedic Hand Surgery Physician	36933	CO

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	:	1710962758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLAN W BACH MD

Provider Business Mailing Address
First Line	:	3010 N CIRCLE DR
Second Line	:	#100
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-1174
Country	:	US
Telephone Number	:	719-632-7669
Fax Number	:	719-632-0088

Provider Business Practice Location Address
First Line	:	3010 N CIRCLE DR
Second Line	:	#100
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-1174
Country	:	US
Telephone Number	:	719-632-7669
Fax Number	:	719-632-0088

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

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	11/01/2007

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