Provider Demographics
NPI:1326760968
Name:REED, STEPHEN A
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:A
Last Name:REED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 E MARKET ST STE 300
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-3271
Mailing Address - Country:US
Mailing Address - Phone:317-955-6933
Mailing Address - Fax:317-955-6943
Practice Address - Street 1:148 E MARKET ST STE 300
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-3271
Practice Address - Country:US
Practice Address - Phone:317-955-6933
Practice Address - Fax:317-955-6943
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1940-14-3158172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver