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Individual

STEVEN R COUNSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1633 N CAPITOL AVE, STE 322, INDIANAPOLIS, IN 46202-1476
(317) 962-2929
(317) 962-2070
Mailing address
250 N SHADELAND AVE, STE 130 - PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
01047736A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000086838
ANTHEM
IN
05
200159720
IN
Enumeration date
04/26/2006
Last updated
11/04/2013
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