Individual
STEPHEN M PESKOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8075 N SHADELAND AVE, SUITE 200, INDIANAPOLIS, IN 46250-2693
(317) 621-8500
(317) 621-8501
Mailing address
920 N SHADELAND AVE, SUITE G1, INDIANAPOLIS, IN 46219-4898
(317) 355-9777
(317) 355-9760
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01025113A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100260610A
—
IN
01
—
4004378
AETNA
IN
Enumeration date
07/19/2005
Last updated
09/17/2009
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