Provider Demographics
NPI:1427366814
Name:BAUER, LEIGH F (DO)
Entity Type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:F
Last Name:BAUER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 772437
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48277-2437
Mailing Address - Country:US
Mailing Address - Phone:317-575-7304
Mailing Address - Fax:317-575-7333
Practice Address - Street 1:10339 DAWSONS CREEK BLVD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-1907
Practice Address - Country:US
Practice Address - Phone:260-999-7147
Practice Address - Fax:888-578-2674
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-20
Last Update Date:2024-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02006131207V00000X
MN55554207VG0400X, 207VX0000X
IN02006131A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics