Provider Demographics
NPI:1245285386
Name:BAUER, PAUL SHERMAN IV (PT)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:SHERMAN
Last Name:BAUER
Suffix:IV
Gender:M
Credentials:PT
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Mailing Address - Street 1:60 CAMBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-1269
Mailing Address - Country:US
Mailing Address - Phone:203-457-9755
Mailing Address - Fax:
Practice Address - Street 1:705 BOSTON POST RD
Practice Address - Street 2:SUITE A5
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2732
Practice Address - Country:US
Practice Address - Phone:203-458-1645
Practice Address - Fax:203-458-1689
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2014-05-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT0067392251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT650001261Medicare PIN