Bo Bauserman, DDS
Individual provider Active NPI Dentist · Parkersburg, WV
NPI 1205529922 · NPPES record last updated May 30, 2023
Key facts
- NPI
- 1205529922
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 4630 (WV)
- Practice address
- 99 Rosemar Rd
Parkersburg, WV 26104-7657 - Phone
- (304) 878-7189
- NPI assigned
- May 30, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.027206 | OH | MD | Dentist |
| 4630 | WV | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30.027206 | OH | |
| Dentist | 122300000X | 4630 | WV | Yes |
Addresses
Primary practice location
99 Rosemar Rd
Parkersburg, WV 26104-7657
Mailing address
99 Rosemar Rd
Parkersburg, WV 26104-7657
Phone (304) 878-7189
Other providers in Parkersburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.