Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 01063730A | IN |
N | 2080N0001X | Neonatal-Perinatal Doctor | 01063730A | IN |
NPI | 1043420581 |
---|---|
Provider Name | Ariel Leigh Stilwell |
First Address | Indianapolis, IN 46268-3129 |
Second Address | Indianapolis, IN 46260-2479 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 21/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200881400 | (05) | IN |