Individual
DR. MATTHEW JOHN BAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
4700 N EAGLE RD # T1960, BOISE, ID 83713-0744
(208) 939-5149
(208) 939-5282
Mailing address
2652 S SIESTA DR, TEMPE, AZ 85282-2968
(330) 495-3667
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
98474
MT
183500000X
Pharmacist
Primary
P9887
ID
183500000X
Pharmacist
S018022
AZ
Other
Enumeration date
06/13/2011
Last updated
06/20/2024
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