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Individual
DR. JESSE E BAUWENS
Active
Individual
DR. JESSE E BAUWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
50174
KY
207X00000X
Orthopaedic Surgery Physician
Primary
61173-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100034131
—
WI
01
—
P01922788
MEDICARE RR KY
KY
Enumeration date
04/09/2012
Last updated
10/17/2018
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