Individual
DR. BRONSON DELBERT STANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 944-9400
(317) 963-1955
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
07001424A
IN
390200000X
Student in an Organized Health Care Education/Training Program
59.000863
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
264430H46
MEDICARE PTAN
IN
05
—
300077686
—
IN
Enumeration date
05/18/2020
Last updated
09/29/2023
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