Provider Demographics
NPI:1477569481
Name:BAUER, DARRIN MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:DARRIN
Middle Name:MICHAEL
Last Name:BAUER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N. WASHINGTON STREET
Mailing Address - Street 2:SUITE 6
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640
Mailing Address - Country:US
Mailing Address - Phone:573-756-8700
Mailing Address - Fax:573-756-8709
Practice Address - Street 1:301 N. WASHINGTON STREET
Practice Address - Street 2:SUITE 6
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640
Practice Address - Country:US
Practice Address - Phone:573-756-8700
Practice Address - Fax:573-756-8709
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001000361111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOU83584Medicare UPIN