Baender, Kelli Ingram
Baender, Kelli Ingram is an sole proprietor health care provider with primary practice located at 3379 Peachtree Rd. Ne Suite 500, Atlanta GA 30326-1418. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Procedural Dermatology. Allopathic & Osteopathic Physicians / Procedural Dermatology is her primary health care specialty. Baender, Kelli Ingram can be contacted via phone (404) 355-5484.Contact Information
Primary practice address
3379 Peachtree Rd. Ne Suite 500
Atlanta GA 30326-1418
Phone: (404) 355-5484
Fax: (404) 355-5787
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 60105 | Georgia |
| Allopathic & Osteopathic Physicians / Procedural Dermatology | 207NS0135X | 60105 | Georgia |
Profile Details
| NPI number | 1093793416 |
|---|---|
| LBN Legal business name | Baender, Kelli Ingram |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 5th, 2006 |
| Last updated | Oct 16th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093793416 | NPPES |
| Arizona | Other | 86080015085259A972 | TRIWEST |
| Arizona | Other | P00231283 | TRIWEST |
| Arizona | MEDICAID | 894057 | TRIWEST |
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