Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 14321 | MS |
N | 208600000X | Surgeon | 14321 | MS |
N | 2086S0102X | Surgical Critical Care | 14321 | MS |
Y | 2086S0127X | Trauma Surgeon | 14321 | MS |
N | 2086S0129X | Vascular Surgeon | 14321 | MS |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 14321 | MS |
NPI | 1083697874 |
---|---|
Provider Name | Dr. Paul Mitchell Bauer |
First Address | Neptune, NJ 07753 |
Second Address | Neptune, NJ 07753-4859 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2005 |
Last Update Date | 30/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02312412 | (05) | NY |
F72536 | (02) |