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Individual

DALE V BAUMAN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2300 HOSPITAL DR, #310, BOSSIER CITY, LA 71111-2394
(318) 752-1502
(318) 752-1504
Mailing address
2300 HOSPITAL DR, BOSSIER CITY, LA 71111-2166
(318) 752-1502
(318) 752-1504

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
04029R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04029R
LA STATE MEDICAL LIC
LA
05
1303976
LA
01
E5348
TX STATE MEDICAL LIC
TX
Enumeration date
03/10/2006
Last updated
07/08/2007
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