Individual
DR. PAUL J HALTER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01059547A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000341265
ANTHEM PIN #
IN
05
—
200303630
—
IN
01
—
200311740E
MCD GRP# & LOCATION
—
01
—
7199596
AETNA PIN #
IN
Enumeration date
08/16/2005
Last updated
10/08/2010
Update your record
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