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Individual

STEPHANIE ROSE MOLINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
700 W IRONWOOD DR STE 130, COEUR D ALENE, ID 83814-4404
(208) 625-4700
(208) 625-4701
Mailing address
PO BOX 3868, SPOKANE, WA 99220-3868
(509) 228-1000
(509) 252-9300

Taxonomy

Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
7761579
ID
2086X0206X
Surgical Oncology Physician
Primary
MD00041718
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010140846
BLUE SHIELD OF IDAHO
01
0164026
LABOR & INDUSTRIES
WA
01
7631MO
ASURIS NW HEALTH
01
7744005
AETNA
05
806453700
ID
05
8322315
WA
01
910000395
RAILROAD MEDICARE
01
KS665
BLUE CROSS OF IDAHO
Enumeration date
10/19/2005
Last updated
07/24/2025
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