Individual
MRS. LAURA T STITLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
53 SOUTH PARK BLVD, GREENWOOD, IN 46143
(317) 889-7546
(317) 889-2482
Mailing address
53 SOUTH PARK BLVD, GREENWOOD, IN 46143
(317) 889-7546
(317) 889-2482
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
01056989A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000306309
ANTHEM
IN
01
—
7268449
AETNA
IN
01
—
7475840
CIGNA
—
Enumeration date
10/04/2006
Last updated
07/24/2007
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