Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 33233 | CO |
NPI | 1316999105 |
---|---|
Provider Name | Dr. Paul Edward Bauer |
First Address | Peyton, CO 80831-9533 |
Second Address | Colorado Springs, CO 80907-4900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 02/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
43222889 | (05) | CO |
G33743 | (02) | CO |