Spicer, Stephen Charles

Spicer, Stephen Charles is an individual health care provider with primary practice located at 1103 E Grace St , Rensselaer IN 47978-3210. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Spicer, Stephen Charles can be contacted via phone (219) 866-4135.

Contact Information

Primary practice address
1103 E Grace St Rensselaer IN 47978-3210
Phone: (219) 866-4135
Fax: (219) 866-0803
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A01021575 Indiana

Profile Details

NPI number 1649266180
LBN Legal business name Spicer, Stephen Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2005
Last updated Jan 20th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649266180 NPPES
Indiana MEDICAID 1002919620
Indiana Other 791083372
Indiana MEDICAID 100219620A

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