1528045804 NPI number — DR. STUART B BAUER MD

Table of content: DR. STUART B BAUER MD (NPI 1528045804)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528045804 NPI number — DR. STUART B BAUER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAUER
Provider First Name:
STUART
Provider Middle Name:
B
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528045804
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/23/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 LONGWOOD AVE
Provider Second Line Business Mailing Address:
CHILDRENS UROLOGICAL FOUNDATION
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02115-5724
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-355-8338
Provider Business Mailing Address Fax Number:
617-730-0474

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 LONGWOOD AVE
Provider Second Line Business Practice Location Address:
CHILDRENS UROLOGICAL FOUNDATION
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02115-5724
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-355-8338
Provider Business Practice Location Address Fax Number:
617-730-0474
Provider Enumeration Date:
12/28/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208800000X , with the licence number:  36354 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2035332 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30011521 . This is a "WNH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8372441001 . This is a "CIG2" identifier . This identifiers is of the category "OTHER".
  • Identifier: 994719 . This is a "NETHE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1900234 . This is a "UHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: Z11048 . This is a "HEALT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1900234 . This is a "UNI4" identifier . This identifiers is of the category "OTHER".
  • Identifier: 702871 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1006644 . This is a "WVT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 101565278 . This is a "CHA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 11273 . This is a "HNE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000009227 . This is a "BMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1900234 . This is a "UNI1" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0012835 . This is a "NHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1900234 . This is a "METRA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1900234 . This is a "UNI7" identifier . This identifiers is of the category "OTHER".
  • Identifier: 36173 . This is a "FCHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: AA8296 . This is a "HPHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: P2697366 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".




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