Provider Demographics
NPI:1346417086
Name:BAUER, MICHAEL JAMES
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JAMES
Last Name:BAUER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SOUTH WILCOX ST # 443
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1913
Mailing Address - Country:US
Mailing Address - Phone:303-589-8124
Mailing Address - Fax:
Practice Address - Street 1:662 YANKAKEE DR
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108
Practice Address - Country:US
Practice Address - Phone:303-589-8124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ37133207ZB0001X
COCDRH.0032677207ZB0001X
FLME98095207ZB0001X
CAG81308207ZB0001X
MN4301072509207ZB0001X
MA236954207ZB0001X
OK30190207ZB0001X
GA60238207ZB0001X
NC2014-02499207ZB0001X
OH35-0085225207ZB0001X
SC37859207ZB0001X
MO2009007649207ZB0001X
TXN8076207ZB0001X
OH35.085225207ZC0006X
CO32677207ZB0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
No207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology