Provider Demographics
NPI:1659361673
Name:BROWN, STEWART C (MD)
Entity Type:Individual
Prefix:DR
First Name:STEWART
Middle Name:C
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:317-621-6333
Mailing Address - Fax:317-621-9676
Practice Address - Street 1:533 E COUNTY LINE RD STE 101
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1074
Practice Address - Country:US
Practice Address - Phone:317-957-9050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01068195A207P00000X
IN01031962207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00004609OtherRAILROAD MEDICARE
IN000000793087OtherANTHEM
IN000000822088OtherANTHEM
IN201019410Medicaid
IN100106230AMedicaid
INP01291714OtherRAILROAD MEDICARE
IN100106230Medicaid
IN000000822088OtherANTHEM
IN201019410Medicaid
IN194590DMedicare PIN