Provider Demographics
NPI:1952873531
Name:BAUER, MAX
Entity Type:Individual
Prefix:
First Name:MAX
Middle Name:
Last Name:BAUER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13921 PLUMBROOK RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-1727
Mailing Address - Country:US
Mailing Address - Phone:586-804-8161
Mailing Address - Fax:586-275-2593
Practice Address - Street 1:13921 PLUMBROOK RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-1727
Practice Address - Country:US
Practice Address - Phone:586-804-8161
Practice Address - Fax:586-275-2593
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-20
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy