Individual
STEPHEN MCCONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2825 BARRY KNOLL WAY, FORT WAYNE, IN 46845-1944
(260) 627-5524
(260) 637-7454
Mailing address
2825 BARRY KNOLL WAY, FORT WAYNE, IN 46845-1944
(260) 627-5524
(260) 637-7454
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01038058
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100331110
—
IN
Enumeration date
07/19/2006
Last updated
12/02/2015
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