Provider Demographics
NPI:1801877246
Name:SZYNAL, STEPHEN (DO)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:SZYNAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 68952
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-0952
Mailing Address - Country:US
Mailing Address - Phone:317-802-6311
Mailing Address - Fax:317-870-0499
Practice Address - Street 1:1605 WINSTED DR
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46526-4655
Practice Address - Country:US
Practice Address - Phone:574-534-8794
Practice Address - Fax:574-534-3082
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-11
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02000805207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN229170Medicare PIN
E45846Medicare UPIN