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General NPI Number Information
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NPI Number | 1518214451
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Entity Type | Individual
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Provider Name | CHRISTOPHER CONLEY STEWART PH.D.
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Gender | Male
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Dates
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Enumeration Date | 08/09/2012
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 355 W 16TH ST STE 2500
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-2280
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Country | US
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Telephone | 317-963-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 250 N SHADELAND AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-4959
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 071008390
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 20043181A
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License Number State | IN
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