Provider Demographics
NPI:1841450608
Name:SZWAST, STANLEY JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:JOSEPH
Last Name:SZWAST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-0070
Mailing Address - Country:US
Mailing Address - Phone:317-845-9322
Mailing Address - Fax:317-845-0599
Practice Address - Street 1:11310 KNIGHTSBRIDGE LN
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-9151
Practice Address - Country:US
Practice Address - Phone:317-845-9322
Practice Address - Fax:317-845-0599
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01063496A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200922410Medicaid
IN200922410Medicaid