Provider Demographics
NPI:1699779587
Name:STONE, DENNIS E (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:E
Last Name:STONE
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 1:4050 CENTRAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203
Mailing Address - Country:US
Mailing Address - Phone:812-376-9427
Mailing Address - Fax:
Practice Address - Street 1:4050 CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47203
Practice Address - Country:US
Practice Address - Phone:812-376-9427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01023999207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000991461OtherANTHEM PIN
IN100342840Medicaid
IN000000991461OtherANTHEM PIN
ININ2762079Medicare PIN
IN250550DMedicare PIN