Provider Demographics
NPI:1417949397
Name:FLORA, STEFANIE (MD)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:
Last Name:FLORA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13420 N MERIDIAN ST STE 300
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1581
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13420 N MERIDIAN ST STE 300
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1581
Practice Address - Country:US
Practice Address - Phone:317-582-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01062839A207V00000X
MISF081406207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4514600Medicaid
IN000000529770OtherBC/BS
MI160029663OtherBXBSM
MI160029663OtherBCN
MI4514600Medicaid
IN222120LMedicare PIN
MI4514600Medicaid
IN222120LMedicare PIN