Provider Demographics
NPI:1811044480
Name:BAUER, MARK H (DC)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:H
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:PO BOX 19624
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66285-9624
Mailing Address - Country:US
Mailing Address - Phone:913-206-6434
Mailing Address - Fax:
Practice Address - Street 1:8620 E 32ND CT N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-4007
Practice Address - Country:US
Practice Address - Phone:316-612-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4073111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor