Individual
STEPHEN R. MYRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
430 W VOTAW ST, PORTLAND, IN 47371-1302
(260) 726-6515
(260) 726-2814
Mailing address
250 N SHADELAND AVE STE 200, INDIANAPOLIS, IN 46219-4959
(317) 962-3834
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0102951A
IN
207Q00000X
Family Medicine Physician
01029521A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100348530
—
IN
Enumeration date
08/23/2005
Last updated
03/29/2022
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