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NPI Code Detail

MEDICARE: STEPHEN R ASH MD

MEDICARE: STEPHEN R ASH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RN0300XNephrology Physician01024554AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
210824713OTHERINCAQH NUMBER
3000000197892OTHERINANTHEM PIN
49396807OTHERINPHCS PID NUMBER

General Provider Information

NPI Number : 1417926940
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN R ASH MD
Provider Business Mailing Address
First Line : PO BOX 5545
Second Line :
City : LAFAYETTE
State : IN
Zip : 47903-5545
Country : US
Telephone Number : 765-448-8000
Fax Number : 765-448-8335
Provider Business Practice Location Address
First Line : 1500 SALEM ST
Second Line :
City : LAFAYETTE
State : IN
Zip : 47904-2164
Country : US
Telephone Number : 765-448-8000
Fax Number : 765-448-8252
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2006
Last Update Date : 01/28/2021

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Directions to “ STEPHEN R ASH MD” Practice Location

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