Provider Demographics
NPI:1205835758
Name:BAUGH, DAVID O (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:O
Last Name:BAUGH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1100 SOUTHFIELD DR
Mailing Address - Street 2:SUITE 1140
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-4498
Mailing Address - Country:US
Mailing Address - Phone:317-839-7200
Mailing Address - Fax:317-837-7926
Practice Address - Street 1:1100 SOUTHFIELD DR
Practice Address - Street 2:SUITE 1140
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-4498
Practice Address - Country:US
Practice Address - Phone:317-839-7200
Practice Address - Fax:317-837-7926
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2011-11-29
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Provider Licenses
StateLicense IDTaxonomies
IN01022957207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100353600Medicaid
IN100353600Medicaid
INC99105Medicare UPIN