Provider Demographics
NPI:1669644795
Name:TRAMBAUGH, HALEY N (MD)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:N
Last Name:TRAMBAUGH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1100 SOUTHFIELD DR
Mailing Address - Street 2:SUITE 1370
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-4498
Mailing Address - Country:US
Mailing Address - Phone:317-837-5571
Mailing Address - Fax:317-837-5580
Practice Address - Street 1:301 SATORIL PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-6405
Practice Address - Country:US
Practice Address - Phone:317-271-6363
Practice Address - Fax:317-271-7600
Is Sole Proprietor?:No
Enumeration Date:2008-03-28
Last Update Date:2021-03-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01065896A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200949640Medicaid
354590QQQMedicare PIN