Individual
STEPHEN M OFFUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
8780 PURDUE RD, SUITE # 7, INDIANAPOLIS, IN 46268-6129
(317) 471-8701
(317) 471-8702
Mailing address
8780 PURDUE RD, SUITE # 7, INDIANAPOLIS, IN 46268-6129
(317) 471-8701
(317) 471-8702
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0700991A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07000991A
STATE LICENSE
IN
01
—
11267445
CAQH
IN
05
—
200268880E
—
IN
05
—
200958540
—
IN
01
—
P01287668
RAILROAD MEDICARE
IN
Enumeration date
05/31/2005
Last updated
03/07/2023
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