Provider Demographics
NPI:1902844053
Name:HALUM, RAMON G (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:G
Last Name:HALUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3001 PALM HARBOR BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-1930
Mailing Address - Country:US
Mailing Address - Phone:727-474-0090
Mailing Address - Fax:727-474-0055
Practice Address - Street 1:853 N EMERSON AVE STE F
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-5763
Practice Address - Country:US
Practice Address - Phone:317-868-7979
Practice Address - Fax:317-743-4070
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN010607072085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00275384OtherRAILROAD MEDICARE
IN200527080Medicaid
IN200527080Medicaid
INH84547Medicare UPIN
IN219950QQQQMedicare PIN