Individual
PHILIP MARK STOLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8040 CLEARVISTA PKWY, INDIANAPOLIS, IN 46256-5630
(317) 621-2000
(317) 614-9655
Mailing address
PO BOX 6005, DEPT 196, INDIANAPOLIS, IN 46206-6005
(317) 614-9817
(317) 614-9655
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01076253A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300002483
—
IN
Enumeration date
06/05/2013
Last updated
11/25/2024
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