Dan F Bautista MD LLC

Family Medicine in Fairborn, OH. Organization (NPI-2).

NPI number1295953933

StatusActive

Last updated in NPPESSep 20, 2023

Details

NPI: 1295953933
Entity type: Organization (NPI-2)
Legal business name: Dan F Bautista MD LLC
Organization subpart: No
Enumeration date: Apr 20, 2007
Certification date: Sep 20, 2023
Last updated: Sep 20, 2023

Medicare and OIG

Medicare enrolled (PECOS): Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
Can order and refer: Not on the CMS order and referring list
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207Q00000X	Family Medicine	35073682B	OH	Yes

Practice location

1840 Commerce Center Blvd
Fairborn, OH 45324-6337

Phone 937-754-4580 · Fax 937-754-4575

Mailing address

1840 Commerce Center Blvd
Fairborn, OH 45324-6337

Phone 937-754-4580 · Fax 937-754-4575

Authorized official

Dan Bautista
Owner
9377544580

Is something wrong?

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Other Family Medicine Physician providers in Fairborn, OH

All 16 Family Medicine Physician providers in Fairborn · All 1,095 providers in Fairborn

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