Provider Demographics
NPI:1215940838
Name:BACH, HAROLD G (MD)
Entity type:Individual
Prefix:
First Name:HAROLD
Middle Name:G
Last Name:BACH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:450 N FEDERAL HWY
Mailing Address - Street 2:#1105
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-4184
Mailing Address - Country:US
Mailing Address - Phone:954-573-0372
Mailing Address - Fax:561-967-3144
Practice Address - Street 1:8200 OKEECHOBEE BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411
Practice Address - Country:US
Practice Address - Phone:561-964-1111
Practice Address - Fax:561-967-3144
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME98091207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN150615000Medicaid
I58467Medicare UPIN
MN200002503Medicare ID - Type Unspecified
MN150615000Medicaid