Provider Demographics
NPI:1811422892
Name:DAUMEYER, ALICIA B (DO)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:B
Last Name:DAUMEYER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:LANGHALS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST
Mailing Address - Street 2:STE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8890 E 116TH ST STE 300
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2857
Practice Address - Country:US
Practice Address - Phone:317-621-1500
Practice Address - Fax:317-621-1509
Is Sole Proprietor?:No
Enumeration Date:2017-04-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02005632A390200000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program