Individual provider · NPI-1

Levi James Bauer

Student in an Organized Health Care Education/Training Program · Norfolk, VA

NPI number1053024232
StatusActive
Last updated in NPPESDec 19, 2023

Details

NPI
1053024232
Entity type
Individual (NPI-1)
Name
Mr. Levi James Bauer
Sex
Male
Sole proprietor
Yes
Enumeration date
Jan 3, 2023
Certification date
Dec 19, 2023
Last updated
Dec 19, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes
207Q00000X Family Medicine0110009378VA

Practice location

1600 Granby St Apt 460
Norfolk, VA 23510-2662

Phone 407-756-5069

Mailing address

1600 Granby St Apt 460
Norfolk, VA 23510-2662

Phone 407-756-5069

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Student in an Organized Health Care Education/Training Program providers in Norfolk, VA