Individual
MICHAEL BRIGGS BAUMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
415 PINEY FOREST RD, DANVILLE, VA 24540-4044
(434) 793-2020
(434) 792-0102
Mailing address
415 PINEY FOREST RD, DANVILLE, VA 24540-4044
(434) 793-2020
(434) 792-0102
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0601001852
VA
152W00000X
Optometrist
Primary
618000253
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807898100
—
VA
Enumeration date
06/17/2005
Last updated
03/17/2018
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