Matthew Lee Bauer, PA-C

NPI #1932504131 in Bonners Ferry, Idaho

Provider Information

NPI Number: 1932504131
Entity Type: Individual
Name: Matthew Lee Bauer, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Oct 30, 2014
Last Updated: Apr 21, 2021

Practice Location

Address: 6615 COMANCHE STREET
City: Bonners Ferry
State: Idaho
ZIP Code: 83805
Phone: (208) 267-1718

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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