Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Ethan Henry Bauer, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1962104869

Dr. Ethan Henry Bauer, MD is a Student in an Organized Health Care Education/Training Program in Boston, Massachusetts. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

330 Brookline Ave
Boston, MA 02215-5400
Phone: (617) 667-7000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1962104869
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 22, 2023
Last updated in NPPESMarch 22, 2023
Certification dateMarch 22, 2023
Mailing address330 Brookline Ave, Boston, MA 02215-5400

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