Individual
JEREMY PAUL BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3101 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3009
(503) 221-3424
(503) 221-3490
Mailing address
PO BOX 8500, LOCKBOX 7642, PHILADELPHIA, PA 19178-7642
(813) 281-8115
(813) 281-8656
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD155424
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500651796
—
OR
Enumeration date
08/13/2006
Last updated
02/17/2017
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