Individual
DR. ENRICO JOSEPH STAZZONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8402 HARCOURT RD STE 100, INDIANAPOLIS, IN 46260-2006
(317) 338-7674
Mailing address
8402 HARCOURT RD STE 100, INDIANAPOLIS, IN 46260-2006
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01079832A
IN
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
01079832A
IN
207XP3100X
Pediatric Orthopaedic Surgery Physician
2003004234
MO
Other
Enumeration date
02/22/2006
Last updated
08/03/2022
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