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General NPI Number Information
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NPI Number | 1639850308
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Entity Type | Individual
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Provider Name | NATHAN ALAN STADNIK PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/26/2023
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Last Update Date | 07/26/2023
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Provider Practice Location Address
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Address Line | 1701 N SENATE AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5306
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Country | US
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Telephone | 317-962-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 25 N NEW JERSEY ST APT 407
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City | INDIANAPOLIS
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State | IN
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Zip | 46204-2888
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26030406A
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License Number State | IN
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