Provider Demographics
NPI:1376758136
Name:BACH, SON M (MD)
Entity Type:Individual
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First Name:SON
Middle Name:M
Last Name:BACH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:6394 THORNBERRY CT
Mailing Address - Street 2:SUITE 820
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-7810
Mailing Address - Country:US
Mailing Address - Phone:513-492-8541
Mailing Address - Fax:513-445-3815
Practice Address - Street 1:6394 THORNBERRY CT
Practice Address - Street 2:SUITE 820
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-7810
Practice Address - Country:US
Practice Address - Phone:513-492-8541
Practice Address - Fax:513-445-3815
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2023-05-03
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Provider Licenses
StateLicense IDTaxonomies
OH093867207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine