Provider Demographics
NPI:1942297122
Name:BAUERS, JOHN (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:BAUERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4979 HARLEM RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-2544
Mailing Address - Country:US
Mailing Address - Phone:716-923-4390
Mailing Address - Fax:716-923-4384
Practice Address - Street 1:4979 HARLEM RD
Practice Address - Street 2:SUITE 1
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-2547
Practice Address - Country:US
Practice Address - Phone:716-923-4380
Practice Address - Fax:716-923-4384
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY132732207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0411538OtherIHA
NY00753911Medicaid
NY151076BJOtherPREFERRED CARE
NY00026114302OtherUNIVERA
NY000507824004OtherBC/BS
NY000507824005OtherBC/BS
NY00026114303OtherUNIVERA
NY080110000016OtherFIDELIS
RA0964Medicare PIN
NY00026114303OtherUNIVERA
NY00753911Medicaid
NY000507824005OtherBC/BS