Organization
IR HALUM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAMON GAYLON HALUM III MD (OWNER)
(317) 254-3688
Entity
Organization
Contact information
Practice address
5953 CALAIS CT, INDIANAPOLIS, IN 46220-6004
(317) 254-3688
Mailing address
5953 CALAIS CT, INDIANAPOLIS, IN 46220-6004
(317) 254-3688
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
01060707A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200527080
—
IN
Enumeration date
01/05/2010
Last updated
01/05/2010
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