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General NPI Number Information
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NPI Number | 1639358963
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Entity Type | Organization
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Legal Business Name | RAYMOND A BAUMGARTNER PC
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Dates
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Enumeration Date | 11/02/2007
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Last Update Date | 11/16/2007
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Provider Practice Location Address
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Address Line | 1717 W 86TH ST STE 400
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-2048
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Country | US
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Telephone | 317-872-8042
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Fax | 317-872-8044
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Provider Business Mailing Address
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Address Line | 1717 W 86TH ST STE 400
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-2048
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Country | US
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Telephone | 317-872-8045
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Fax | 317-872-8044
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. RAYMOND ALAN BAUMGARTNER
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Credential | PC
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Telephone | 317-872-8042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 07000742A
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License Number State | IN
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