Individual
TIFFANY J. BAUMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ST
Contact information
Practice address
2516 E DUPONT RD, FORT WAYNE, IN 46825-1608
(260) 490-4800
(260) 497-8399
Mailing address
7309 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6237
(260) 432-4700
(260) 459-9262
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004296A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
156546
GROUP MEDICARE
IN
Enumeration date
12/03/2008
Last updated
12/03/2008
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