Provider Demographics
NPI:1407807068
Name:BAUER, DAVID E (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:BAUER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:100 BROOKSHIRE BLVD
Mailing Address - Street 2:BLDG 2, STE 2
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6686
Mailing Address - Country:US
Mailing Address - Phone:406-656-8886
Mailing Address - Fax:406-655-9691
Practice Address - Street 1:2675 CENTRAL AVE
Practice Address - Street 2:SUITE L1
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6686
Practice Address - Country:US
Practice Address - Phone:406-656-8886
Practice Address - Fax:406-655-9691
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT755152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTP00723682OtherRAILROAD NUMBER
MTP00723682OtherRAILROAD NUMBER