Individual
ANDREW F STASIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
702 BARNHILL DR, INDIANAPOLIS, IN 46202-5128
(317) 274-0273
(317) 567-2191
Mailing address
1120 SOUTH DR, FESLER HALL, RM 204, INDIANAPOLIS, IN 46202-5135
(317) 274-0273
(317) 567-2191
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01040285
IN
207LP3000X
Pediatric Anesthesiology Physician
Primary
01040285
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100324940
—
IN
Enumeration date
05/16/2006
Last updated
12/21/2009
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