Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | SC002548-L | PA |
Y | 222Z00000X | Podiatrist | SC002548-L | PA |
N | 213EP1101X | Primary Podiatric Medicine | SC002548-L | PA |
N | 213ES0103X | Foot & Ankle Surgery | SC002548-L | PA |
NPI | 1174759310 |
---|---|
Provider Name | Dr. Robert F. Bauer |
First Address | Erie, PA 16504-1559 |
Second Address | Erie, PA 16504-1559 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2009 |
Last Update Date | 11/01/2017 |