Provider Demographics
NPI:1447292362
Name:BAUER, ROBERT M (M D)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:BAUER
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-2528
Mailing Address - Country:US
Mailing Address - Phone:716-433-4999
Mailing Address - Fax:716-434-0831
Practice Address - Street 1:445 MARKET ST
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-2528
Practice Address - Country:US
Practice Address - Phone:716-433-4999
Practice Address - Fax:716-434-0831
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY166262207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000100125001OtherUNIVERA ID NUMBER
NY00050095901OtherBLUE CROSS WNY ID NUMBER
NY0905288OtherINDEPENDENT HEALTH ID NUM
NY00973717Medicaid
NY00973717Medicaid
NY000100125001OtherUNIVERA ID NUMBER