Provider Demographics
NPI:1629018247
Name:BAUMAN, ALAN E (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:E
Last Name:BAUMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7701 STATE LINE RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-1635
Mailing Address - Country:US
Mailing Address - Phone:816-444-2900
Mailing Address - Fax:816-444-3304
Practice Address - Street 1:7701 STATE LINE RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-1635
Practice Address - Country:US
Practice Address - Phone:816-444-2900
Practice Address - Fax:816-444-3304
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO-R7F23207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO12589060OtherBCBS-CC LOCATION
MO12589090OtherBCBS- SL LOCATION
MO202294013Medicaid
KS100177070BMedicaid
KS100177070BMedicaid
MO12589060OtherBCBS-CC LOCATION
MOJ065819Medicare PIN
MOH495819Medicare PIN
MOH505819Medicare PIN