MEDICARE: DR. CHRISTOPHER CONLEY STEWART PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist	071008390	IL
2	103G00000X	Clinical Neuropsychologist	20043181A	IN

General Provider Information

NPI Number	:	1518214451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER CONLEY STEWART PH.D.

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	355 W 16TH ST STE 2500
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-2280
Country	:	US
Telephone Number	:	317-963-7400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2012
Last Update Date	:	03/12/2025

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