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Individual

MAXINE BAUER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
9427 SW BARNES RD, SUITE 395, PORTLAND, OR 97225-6652
(503) 216-2602
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD20753
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
134047
OR
Enumeration date
09/07/2005
Last updated
02/05/2021
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