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General NPI Number Information
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NPI Number | 1235542101
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Entity Type | Individual
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Provider Name | PETER H BAENZIGER MD
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Gender | Male
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Dates
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Enumeration Date | 06/08/2014
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Last Update Date | 05/20/2022
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Provider Practice Location Address
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Address Line | 8424 NAAB RD STE 1H
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-1954
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Country | US
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Telephone | 317-338-8680
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Fax |
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Provider Business Mailing Address
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Address Line | 8424 NAAB RD STE 1H
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-1954
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 11017673A.
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | 01078975A
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License Number State | IN
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