Individual
DR. STEPHANIE HARRISON HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 751-5404
Mailing address
1200 W WHITE RIVER BLVD, RCS PROVIDER ENROLLMENT, MUNCIE, IN 47303-4988
(765) 254-4009
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01080270A
IN
207L00000X
Anesthesiology Physician
D0060671
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
403262400
—
MD
Enumeration date
12/12/2005
Last updated
07/09/2019
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