Provider Demographics
NPI:1487989646
Name:BAUER, YISRAEL MEIR (DO)
Entity type:Individual
Prefix:DR
First Name:YISRAEL
Middle Name:MEIR
Last Name:BAUER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 PEMBROKE RD
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-2724
Mailing Address - Country:US
Mailing Address - Phone:215-485-8617
Mailing Address - Fax:
Practice Address - Street 1:403 PEMBROKE RD
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-2724
Practice Address - Country:US
Practice Address - Phone:215-485-8617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-06
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS016008207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services