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Individual

STEPHANIE E. DUNKLE-BLATTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01066021A
IN
208600000X
Surgery Physician
Primary
35.121953
OH
208600000X
Surgery Physician
40576
KY
2086S0129X
Vascular Surgery Physician
01066021A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101266510
PA
01
36000818
ASC MEDICAID GROUP
KY
01
37903705
MEDICAID LAB GROUP
KY
01
4000501
MEDICARE LAB GROUP
KY
05
7100020980
KY
01
ASC1019
ASC MEDICARE GROUP
KY
01
CB5773
RR MEDICARE GROUP
KY
01
P00397697
RR MEDICARE PIN
KY
Enumeration date
02/28/2006
Last updated
02/11/2025
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