Provider Demographics
NPI:1316082506
Name:BAUER, PAUL GABRIEL (DC DOCTOR OF CHIROPR)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:GABRIEL
Last Name:BAUER
Suffix:
Gender:M
Credentials:DC DOCTOR OF CHIROPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7758 BEECHMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-4214
Mailing Address - Country:US
Mailing Address - Phone:513-232-5999
Mailing Address - Fax:513-232-5899
Practice Address - Street 1:7758 BEECHMONT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-4214
Practice Address - Country:US
Practice Address - Phone:513-232-5999
Practice Address - Fax:513-232-5899
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3592111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH593822091Medicaid
OH000000385294OtherBCBS
V05925Medicare UPIN
OH593822091Medicaid