Basic Information
| Provider Information | |||||||||
| NPI: | 1225238090 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STELL | ||||||||
| FirstName: | SYLVIA | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11109 PARKVIEW PLAZA DR # 117 | ||||||||
| Address2: | |||||||||
| City: | FORT WAYNE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 468451701 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1270 E STATE ROAD 205 STE 140 | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA CITY | ||||||||
| State: | IN | ||||||||
| PostalCode: | 467258505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2602489090 | ||||||||
| FaxNumber: | 2602489095 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2007 | ||||||||
| LastUpdateDate: | 06/10/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 01064135A | IN | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.