Provider Demographics
NPI:1366959033
Name:BAUER, SALLY E (MD)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:E
Last Name:BAUER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75995 OVERSEAS HWY
Mailing Address - Street 2:
Mailing Address - City:ISLAMORADA
Mailing Address - State:FL
Mailing Address - Zip Code:33036-4019
Mailing Address - Country:US
Mailing Address - Phone:305-664-2784
Mailing Address - Fax:
Practice Address - Street 1:75995 OVERSEAS HWY
Practice Address - Street 2:
Practice Address - City:ISLAMORADA
Practice Address - State:FL
Practice Address - Zip Code:33036-4019
Practice Address - Country:US
Practice Address - Phone:305-664-2784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-03
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHME35.039704207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine