Bautista, Dan F
Bautista, Dan F is an sole proprietor health care provider with primary practice located at 1840 Commerce Center Blvd , Fairborn OH 45324-6337. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bautista, Dan F can be contacted via phone (937) 754-4580.Contact Information
Primary practice address
1840 Commerce Center Blvd
Fairborn OH 45324-6337
Phone: (937) 754-4580
Fax: (937) 754-4575
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 35073682B | Ohio |
Profile Details
| NPI number | 1629006903 |
|---|---|
| LBN Legal business name | Bautista, Dan F |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 28th, 2006 |
| Last updated | Sep 19th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629006903 | NPPES |
| Ohio | Other | 300107 | AMERIGROUP PIN |
| Ohio | Other | D7368201 | AMERIGROUP PIN |
| Ohio | Other | 310809436DAB | AMERIGROUP PIN |
| Ohio | Other | 32004929300 | AMERIGROUP PIN |
| Ohio | Other | 5405631 | AMERIGROUP PIN |
| Ohio | Other | 2897281 | AMERIGROUP PIN |
| Ohio | MEDICAID | 2080233 | AMERIGROUP PIN |
| Ohio | MEDICAID | 2871969 | AMERIGROUP PIN |
| Ohio | Other | 320049293027 | AMERIGROUP PIN |
| Ohio | Other | 000000259761 | AMERIGROUP PIN |
| Ohio | Other | 0109918 | AMERIGROUP PIN |
| Ohio | Other | P12036623 | AMERIGROUP PIN |
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