Individual
DR. PAUL J HALTER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 E BOYD AVE STE 250, GREENFIELD, IN 46140-2845
(317) 467-4500
(317) 477-6321
Mailing address
PO BOX 129, GREENFIELD, IN 46140-0129
(317) 468-6270
(317) 468-6268
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
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