Provider Demographics
NPI:1710988795
Name:AHLFELD, STEVEN KRIS (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:KRIS
Last Name:AHLFELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:STEVEN
Other - Middle Name:KRIS
Other - Last Name:AHLFELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:9302 N MERIDIAN ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1873
Mailing Address - Country:US
Mailing Address - Phone:317-575-6515
Mailing Address - Fax:317-844-8347
Practice Address - Street 1:9302 N MERIDIAN ST
Practice Address - Street 2:SUITE 110
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1873
Practice Address - Country:US
Practice Address - Phone:317-575-6515
Practice Address - Fax:317-844-8347
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01028922207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN822770Medicaid
IN822770Medicare PIN
IND70783Medicare UPIN
IN256560AMedicare PIN