Organization
M. D. HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK KEVIN STINE M.D. (OWNER/PHYSICIAN)
(317) 610-3003
Entity
Organization
Contact information
Practice address
6920 PARKDALE PL, SUITE 208, INDIANAPOLIS, IN 46254-5612
(317) 610-3003
(317) 610-3005
Mailing address
6920 PARKDALE PL, SUITE 208, INDIANAPOLIS, IN 46254-5612
(317) 610-3003
(317) 610-3005
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01030274A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100330510B
—
IN
01
—
1316942303
INDIVIDUAL NPI
IN
01
—
229510A
INDIVIDUAL MEDICARE PIN
IN
Enumeration date
10/25/2007
Last updated
03/16/2010
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