Individual
STACY M KRITZMIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
705 RILEY HOSPITAL DR, RI 2001, INDIANAPOLIS, IN 46202-5128
(317) 944-9981
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
02002593
IN
207LP3000X
Pediatric Anesthesiology Physician
Primary
02002593
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200459280
—
IN
Enumeration date
05/14/2006
Last updated
11/30/2020
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