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Individual

JOHN BAUER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
38935 ANN ARBOR RD, LIVONIA, MI 48150-3397
(734) 632-0175
(734) 632-0182
Mailing address
38935 ANN ARBOR RD, LIVONIA, MI 48150-3397
(734) 632-0175
(734) 632-0182

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101243662
VA
207P00000X
Emergency Medicine Physician
Primary
4301051601
MI
207P00000X
Emergency Medicine Physician
MD433073
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11271565
CAQH
05
1346258233
MI
05
1346258233
VA
Enumeration date
08/04/2006
Last updated
07/10/2015
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