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DR. BAUER-OLSON FAMILY DOCTOR PLLC NPI 1588234066


NPI Information

NPI: 1588234066
Provider Name: DR. BAUER-OLSON, FAMILY DOCTOR, PLLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 35D2285509

Address:
4133 30TH AVE S STE 103
FARGO, ND
ZIP 58104
Phone: (701) 499-4847
Get Directions

DR. BAUER-OLSON, FAMILY DOCTOR, PLLC is a family medicine in Fargo, ND. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. BAUER-OLSON, FAMILY DOCTOR, PLLC NPI is 1588234066. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4133 30TH AVE S STE 103
FARGO, ND
ZIP 58104-421
Phone: (701) 499-4847
Fax: (701) 433-1882

The provider's authorized official is Cheryl K Bauer-olson .
The authorized official title is Owner and has the following contact phone number (701) 499-4847.

The CLIA number assigned to this NPI record is 35D2285509 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/28/2021 and was last updated on 5/15/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
114436MEDICAIDNORTH DAKOTA
21484174MEDICAIDNORTH DAKOTA
34754236OTHERMINNESOTABCBSMN
41588234066OTHERNORTH DAKOTANDBS
51588234066MEDICAIDMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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