Healthcare Provider Details

I. General information

NPI: 1841450608
Provider Name (Legal Business Name): STANLEY JOSEPH SZWAST M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2008
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11310 KNIGHTSBRIDGE LN
FISHERS IN
46037-9151
US

IV. Provider business mailing address

PO BOX 70
FISHERS IN
46038-0070
US

V. Phone/Fax

Practice location:
  • Phone: 317-845-9322
  • Fax: 317-845-0599
Mailing address:
  • Phone: 317-845-9322
  • Fax: 317-845-0599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number01063496A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: