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Individual

BENJAMIN D BAUER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
705 RILEY HOSPITAL DR, STE 1721, INDIANAPOLIS, IN 46202-5109
(317) 962-8067
(317) 962-3796
Mailing address
PO BOX 1026, INDIANAPOLIS, IN 46206-1026
(317) 274-1201
(317) 278-9905

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01062493A
IN
208000000X
Pediatrics Physician
Primary
01062493A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1295743086
MI
05
200828830
IN
Enumeration date
08/04/2006
Last updated
03/28/2011
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