Individual
STEPHANIE P HOLZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
550 UNIVERSITY BLVD, RADIOLOGY DEPT, INDIANAPOLIS, IN 46202-5149
(317) 278-9729
(317) 278-7055
Mailing address
250 N SHADELAND AVE, SUITE 130, INDIANAPOLIS, IN 46219-4959
(317) 963-0860
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01066378A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200946170
—
IN
01
—
P00764116
RAILROAD MEDICARE
IN
Enumeration date
04/02/2009
Last updated
02/02/2021
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