Healthcare Provider Details

I. General information

NPI: 1932668753
Provider Name (Legal Business Name): STEPHANIE LYNN CARMEAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 SILHAVY RD STE 100
VALPARAISO IN
46383-9583
US

IV. Provider business mailing address

9200 CALUMET AVE STE N203
MUNSTER IN
46321-5810
US

V. Phone/Fax

Practice location:
  • Phone: 219-228-4200
  • Fax:
Mailing address:
  • Phone: 219-221-1619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number01089379A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number036.161178
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: