Individual
KEVIN MARTIN BAUMGARTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(419) 806-7631
Mailing address
4905 IRIS AVE APT 626, FORT WAYNE, IN 46825-2791
(419) 806-7631
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26030020A
IN
Other
Enumeration date
10/10/2022
Last updated
10/10/2022
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