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Individual

MRS. ANNA MARIE BAUER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1289 HEMBREE RD, SUITE 200-A, ROSWELL, GA 30076
(770) 475-2710
(770) 475-0078
Mailing address
1289 HEMBREE RD, SUITE 200-A, ROSWELL, GA 30076
(770) 475-2710
(770) 475-0078

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001950
GA
363AS0400X
Surgical Physician Assistant
Primary
001950
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
612060161A
GA
Enumeration date
10/18/2005
Last updated
06/13/2017
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