Individual
ERIC WYGANT STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2400 SOUTH ST, LAFAYETTE, IN 47904-3027
(765) 448-4319
(765) 448-2821
Mailing address
PO BOX 5628, LAFAYETTE, IN 47903-5628
(765) 448-4319
(765) 448-2921
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01030271A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000082506
ANTHEM
IN
01
—
111890E
MEDICARE
IN
01
—
176600B
MEDICARE
IN
01
—
CA8380
RAIL ROAD MEDICARE
IN
Enumeration date
07/09/2005
Last updated
07/16/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us