Provider Demographics
NPI:1710206974
Name:BAUMAN, MATTHEW JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JOHN
Last Name:BAUMAN
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 1:860 8TH ST
Mailing Address - Street 2:
Mailing Address - City:TRAFFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15085-1136
Mailing Address - Country:US
Mailing Address - Phone:412-860-6780
Mailing Address - Fax:
Practice Address - Street 1:548B HARRISON CITY RD
Practice Address - Street 2:
Practice Address - City:TRAFFORD
Practice Address - State:PA
Practice Address - Zip Code:15085-1338
Practice Address - Country:US
Practice Address - Phone:412-373-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-26
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010290111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA002522222OtherHIGHMARK BLUE SHIELD