Healthcare Provider Details

I. General information

NPI: 1407880750
Provider Name (Legal Business Name): SHEILA DENISE STEWART M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHEILA DENISE STEWART-WHACK M.D.

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 01/19/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 PIT RD
BROWNSBURG IN
46112
US

IV. Provider business mailing address

590 PIT RD
BROWNSBURG IN
46112-7830
US

V. Phone/Fax

Practice location:
  • Phone: 317-456-1100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01051181 A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: