Provider Demographics
NPI:1952492373
Name:BERGSTEIN, STEPHANIE ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ANN
Last Name:BERGSTEIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:12065 OLD MERIDIAN ST
Mailing Address - Street 2:#100
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-8773
Mailing Address - Country:US
Mailing Address - Phone:317-844-5351
Mailing Address - Fax:317-844-0310
Practice Address - Street 1:12065 OLD MERIDIAN ST
Practice Address - Street 2:#100
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-8773
Practice Address - Country:US
Practice Address - Phone:317-844-5351
Practice Address - Fax:317-844-0310
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2008-03-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01042405208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics