Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 01060979A | IN |
N | 207P00000X | Emergency Physician | 125055620 | IL |
N | 207P00000X | Emergency Physician | 249860 | MA |
N | 2086S0102X | Surgical Critical Care | 249860 | MA |
N | 208D00000X | General Practice Physician | 01060979A | IN |
NPI | 1063485746 |
---|---|
Provider Name | Christine Renee Stehman |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-1239 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2006 |
Last Update Date | 23/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201040050 | (05) | IN |