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NPI Code Detail

MEDICARE: DR. ROGER SCOTT STIENECKER M.D. FACP FSHEA

MEDICARE: DR. ROGER SCOTT STIENECKER M.D. FACP FSHEA
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
1207RI0200XInfectious Disease Physician35066788SOH
2207RI0200XInfectious Disease Physician01070327AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P01039781OTHERINRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4000000739208OTHERINANTHEM

General Provider Information

NPI Number : 1962494971
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROGER SCOTT STIENECKER M.D. FACP FSHEA
Provider Business Mailing Address
First Line : 11109 PARKVIEW PLAZA DR # 117
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2231 CAREW ST
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-4713
Country : US
Telephone Number : 260-373-9935
Fax Number : 260-373-9926
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2005
Last Update Date : 10/20/2022

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