Individual
DR. STACEY ISHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8402 HARCOURT RD STE 400, INDIANAPOLIS, IN 46260-2053
(317) 338-6815
Mailing address
PO BOX 933432, CLEVELAND, OH 44193-0039
(937) 641-5072
(937) 641-6129
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
01088233A
IN
207YP0228X
Pediatric Otolaryngology Physician
35.121930
OH
207YS0012X
Sleep Medicine (Otolaryngology) Physician
35.121930
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0091250
—
OH
Enumeration date
05/27/2006
Last updated
04/09/2026
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