Provider Demographics
NPI:1699735738
Name:STOKAR, ELLIOT H (MD)
Entity type:Individual
Prefix:
First Name:ELLIOT
Middle Name:H
Last Name:STOKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:757 45TH AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2911
Mailing Address - Country:US
Mailing Address - Phone:219-934-2461
Mailing Address - Fax:219-934-2478
Practice Address - Street 1:761 45TH AVE
Practice Address - Street 2:STE 108
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2893
Practice Address - Country:US
Practice Address - Phone:219-922-5416
Practice Address - Fax:219-922-3745
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01030852207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100361810AMedicaid
E03946Medicare UPIN
IN100361810AMedicaid