Individual
DR. ROGER SCOTT STIENECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D. FACP FSHEA
Contact information
Practice address
2231 CAREW ST, FORT WAYNE, IN 46805-4713
(260) 373-9935
(260) 373-9926
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
01070327A
IN
207RI0200X
Infectious Disease Physician
35066788S
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000739208
ANTHEM
IN
05
—
0976421
—
OH
05
—
201040910
—
IN
01
—
P01039781
RR MEDICARE
IN
Enumeration date
08/16/2005
Last updated
10/20/2022
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