Individual
JENNIFER LANTER STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1120 SOUTH DR # FH204, INDIANAPOLIS, IN 46202-5135
(317) 274-0076
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
02004014A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000822379
ANTHEM PTAN
IN
05
—
201108320
—
IN
Enumeration date
05/28/2009
Last updated
11/25/2024
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