Individual
MICHAEL CARY STALNECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8040 CLEARVISTA PKWY, SUITE 210, INDIANAPOLIS, IN 46256-5630
(317) 621-2200
(317) 621-2204
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
01037409
IN
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
01037409
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000736570
ANTHEM
IN
05
—
100128900
—
IN
01
—
P01125741
RAILROAD MEDICARE
IN
Enumeration date
10/06/2006
Last updated
07/10/2015
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