Individual
DR. TERRY D BAUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 EAST MOUNTAIN BLVD., WILKES-BARRE, PA 18711-3610
(570) 808-6020
(570) 808-2306
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
0101273997
VA
207RC0000X
Cardiovascular Disease Physician
K6811
TX
207RC0000X
Cardiovascular Disease Physician
Primary
MD052361L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024741150001
—
PA
Enumeration date
10/20/2005
Last updated
07/13/2022
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