Individual
BURGUNDY SHAREE STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
250 N SHADELAND AVE, SUITE 130, INDIANAPOLIS, IN 46219-4959
(317) 963-2514
(317) 962-4343
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01076914A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201364410
—
IN
Enumeration date
04/15/2013
Last updated
03/12/2025
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