Provider Demographics
NPI:1538390026
Name:BAUMAN, ZACHARY MITCHEL (DO, MHA)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:MITCHEL
Last Name:BAUMAN
Suffix:
Gender:M
Credentials:DO, MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:988102 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-8102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:EMILY AT 42ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-3280
Practice Address - Country:US
Practice Address - Phone:402-559-9696
Practice Address - Fax:402-559-6749
Is Sole Proprietor?:No
Enumeration Date:2009-07-31
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101018390208600000X
NE14962086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery