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Individual

MS. CAROLYN A. BAUER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1651 GALISTEO ST STE 8, SANTA FE, NM 87505-4752
(505) 820-9870
(505) 983-1265
Mailing address
PO BOX 603725, CHARLOTTE, NC 28260-3725
(828) 575-2625
(828) 350-2174

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA20080043
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
636510AU6T
MEDICARE PTAN
NM
05
74909754
NM
Enumeration date
09/29/2008
Last updated
10/30/2023
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