Individual
DAVID HALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1345 UNITY PL, SUITE 235, LAFAYETTE, IN 47905-5760
(765) 446-5065
(765) 446-5170
Mailing address
PO BOX 4699, LAFAYETTE, IN 47903-4699
(765) 449-2732
(765) 449-1196
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
02004060A
IN
208600000X
Surgery Physician
5101017407
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201106870
—
IN
Enumeration date
08/22/2007
Last updated
02/08/2014
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