Individual
RUTH ELIZABETH STANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
355 W 16TH ST, INDIANAPOLIS, IN 46202-2207
(317) 963-7070
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
01084035A
IN
208100000X
Physical Medicine & Rehabilitation Physician
R4181
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300040243
—
IN
01
—
MEDICARE
068010634
IN
Enumeration date
04/07/2016
Last updated
12/22/2022
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