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Individual

DR. STANLEY E. OSMUNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ED.D.

Contact information

Practice address
3850 SHORE DR STE 303, INDIANAPOLIS, IN 46254-4693
(317) 328-1200
(317) 328-1200
Mailing address
3850 SHORE DR STE 303, INDIANAPOLIS, IN 46254-4693
(317) 328-1200
(317) 328-1200

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20040222A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000184223
ANTHEM BLUE CROSS BLUE SH
IN
Enumeration date
11/15/2006
Last updated
07/08/2007
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