Individual
DR. JOHN WILLEM STUY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2705 N LEBANON ST, SUITE 315, LEBANON, IN 46052-8621
(765) 485-8855
(765) 485-8850
Mailing address
2705 N LEBANON ST, SUITE 315, LEBANON, IN 46052-8621
(765) 485-8855
(765) 485-8850
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01037305A
IL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
01037305A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100354540
—
IN
Enumeration date
11/23/2005
Last updated
10/26/2015
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