Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 01078975A | IN |
NPI | 1235542101 |
---|---|
Provider Name | Dr. Peter H Baenziger |
First Address | Indianapolis, IN 46260-1316 |
Second Address | Indianapolis, IN 46260-1954 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2014 |
Last Update Date | 01/10/2018 |