Individual
DR. EVAN G BAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3201 W PEORIA AVE, SUITE C-600, PHOENIX, AZ 85029-4608
(602) 866-3344
(602) 375-2088
Mailing address
3201 W PEORIA AVE, SUITE C-600, PHOENIX, AZ 85029-4608
(602) 866-3344
(602) 375-2088
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
13703
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121777
HEALTHNET
—
01
—
1407058324
ORGANIZATION NPI#
AZ
01
—
AZ0051960
BCBS
—
Enumeration date
11/15/2005
Last updated
07/08/2007
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