Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301047509 | MI |
N | 111NI0900X | Internist | 4301047509 | MI |
N | 207RI0200X | Infectious Disease | 4301047509 | MI |
NPI | 1033144456 |
---|---|
Provider Name | David Baumgartner |
First Address | Grand Rapids, MI 49503-4328 |
Second Address | Grand Rapids, MI 49503-4607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2778065 | (05) | MI |
4120830 | (05) | MI |
4877160 | (05) | MI |
4879058 | (05) | MI |
B45526 | (02) | MI |