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Individual

STEPHEN E. MAININI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
707 SHERIDAN AVE, CODY, WY 82414
(307) 527-7501
Mailing address
707 SHERIDAN AVE, CODY, WY 82414-3409
(307) 527-7501

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5225A
WY
207RP1001X
Pulmonary Disease Physician
Primary
5225A
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0116376
MT MDCD PIN
MT
01
108527100
WY MDCD PIN
WY
01
314478
BCBS PIN
WY
01
314481
WYOMING BCBS
WY
01
925161030920
PREFERRED ONE PIN
WY
Enumeration date
09/06/2006
Last updated
10/05/2020
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