Individual
DAWANA L STUBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1001 W 10TH ST, INDIANAPOLIS, IN 46202-2859
(317) 639-6671
Mailing address
8910 PURDUE RD, STE.500, INDIANAPOLIS, IN 46268-6100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01045347A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100415960
—
IN
Enumeration date
05/04/2006
Last updated
03/09/2009
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