Individual
MR. WARLITO AVILES BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1311 SPRING ST, JEFFERSONVILLE, IN 47130-3705
(812) 282-3032
(812) 282-3059
Mailing address
1311 SPRING ST, JEFFERSONVILLE, IN 47130-3705
(812) 282-3032
(812) 282-3059
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01026833A
IN
207RP1001X
Pulmonary Disease Physician
01026833A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100075350A
—
IN
Enumeration date
08/30/2005
Last updated
08/04/2008
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