Provider Demographics
NPI:1285906180
Name:CAMPUS CENTER STUDENT HEALTH
Entity type:Organization
Organization Name:CAMPUS CENTER STUDENT HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:WINTERMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-278-2603
Mailing Address - Street 1:420 UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 213
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5147
Mailing Address - Country:US
Mailing Address - Phone:317-274-2274
Mailing Address - Fax:317-278-7657
Practice Address - Street 1:420 UNIVERSITY BLVD
Practice Address - Street 2:SUITE 213
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5147
Practice Address - Country:US
Practice Address - Phone:317-274-2274
Practice Address - Fax:317-278-7657
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IUPUI HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health