Individual
MR. LEVI JAMES BAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1600 GRANBY ST APT 460, NORFOLK, VA 23510-2662
(407) 756-5069
Mailing address
1600 GRANBY ST APT 460, NORFOLK, VA 23510-2662
(407) 756-5069
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0110009378
VA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/03/2023
Last updated
12/19/2023
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