Individual
KENNETH P STUMPF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
6626 E 75TH ST, STE 500, INDIANAPOLIS, IN 46250-2805
(317) 621-7584
(317) 574-5185
Mailing address
3077 E 98TH ST, STE 100, INDIANAPOLIS, IN 46280-2940
(317) 843-2613
(317) 574-5185
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
41000235A
IN
213ES0103X
Foot & Ankle Surgery Podiatrist
07001125A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201082910
—
IN
01
—
768265
BCBS
IN
01
—
9348862
AETNA
IN
01
—
P01405428
RAILROAD MEDICARE
IN
Enumeration date
07/20/2009
Last updated
11/27/2023
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