Individual
STEVEN DEAN MONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1801 N SENATE BLVD STE 635, INDIANAPOLIS, IN 46202-1212
(317) 963-1400
(317) 962-2595
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
02005334A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11017307A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300018265
—
IN
Enumeration date
06/14/2013
Last updated
12/22/2020
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