Individual
JAY JULIUS BAUDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1527 BROADWAY ST, ALEXANDRIA, MN 56308-2537
(320) 762-0399
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
52931
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-42338
MEDICA
—
01
—
1972737054
BCBS
MN
01
—
1972737054
RAILROAD MEDICARE
—
05
—
1972737054
—
MN
Enumeration date
05/05/2009
Last updated
10/13/2021
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