Provider Demographics
NPI:1902887276
Name:BAUER, WILLIAM M (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:M
Last Name:BAUER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2601 CHERRY AVE
Mailing Address - Street 2:STE 213
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-4203
Mailing Address - Country:US
Mailing Address - Phone:360-479-6041
Mailing Address - Fax:360-405-0768
Practice Address - Street 1:2601 CHERRY AVE
Practice Address - Street 2:STE 213
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-4203
Practice Address - Country:US
Practice Address - Phone:360-479-6041
Practice Address - Fax:360-405-0768
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2011-03-07
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Provider Licenses
StateLicense IDTaxonomies
WA35422207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8211682Medicaid
WA8211682Medicaid
GAB34214Medicare ID - Type Unspecified