Individual
MATTHEW DALE BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1222 S PATTERSON BLVD STE 230, DAYTON, OH 45402-2643
(937) 853-3650
(937) 208-6641
Mailing address
1105 SCHROCK RD STE 400, COLUMBUS, OH 43229-1174
(614) 643-6832
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34.011699
OH
207RI0200X
Infectious Disease Physician
Primary
34.011699
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0231564
—
OH
Enumeration date
03/27/2012
Last updated
10/28/2022
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