Individual
MARY JO STINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
35 BOB BABBS DR, SPENCER, IN 47460-6828
(812) 665-1700
(844) 605-9160
Mailing address
8003 CASTLEWAY DR, INDIANAPOLIS, IN 46250-1946
(317) 576-1335
(844) 397-1311
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01029565A
IN
2080N0001X
Neonatal-Perinatal Medicine Physician
01029565A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100330490
—
IN
Enumeration date
10/11/2005
Last updated
01/24/2023
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