Individual
MELISSA H STANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
705 RILEY HOSPITAL DR, 0860, INDIANAPOLIS, IN 46202-5109
(317) 630-8970
(317) 630-8958
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
23002060A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000835781
ANTHEM PROVIDER NUMBER
IN
05
—
200646660
—
IN
Enumeration date
12/10/2012
Last updated
05/04/2017
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