Individual
MR. MATTHEW JOSEPH BAUCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPSGT
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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