Individual
JOHN H STOREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8075 N SHADELAND AVE, SUITE 200, INDIANAPOLIS, IN 46250-2693
(317) 621-8500
(317) 621-8501
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01054684A
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
01054684
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000200146
ANTHEM
—
01
—
000000569479
ANTHEM
IN
05
—
200333850
—
IN
01
—
399892
WELLCARE
IN
01
—
5528673
AETNA
IN
01
—
CB8082
TRICARE
—
01
—
P01209643
RR MEDICARE PTAN
IN
Enumeration date
10/11/2006
Last updated
06/14/2021
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