Individual
DR. PETER JEROME BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13450 N MERIDIAN ST STE 354, CARMEL, IN 46032-1486
(317) 338-5100
Mailing address
13450 N MERIDIAN ST STE 354, CARMEL, IN 46032-1486
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01060754A
IN
207RN0300X
Nephrology Physician
Primary
01060754A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200826270
—
IN
Enumeration date
05/26/2006
Last updated
06/06/2022
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