Individual
STEVEN M WAKEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 944-6201
(317) 968-1482
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
01088098A
IN
207T00000X
Neurological Surgery Physician
0116028848
VA
390200000X
Student in an Organized Health Care Education/Training Program
0116028848
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068010827
MEDICARE
IN
05
—
300066767
—
IN
Enumeration date
06/20/2013
Last updated
03/21/2023
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