Individual
DR. STEVEN EMMET CIABATTONI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 FRONT AVENUE, SUITE #502, COEUR D ALENE, ID 83814
(208) 415-0524
(208) 763-3644
Mailing address
601 FRONT AVENUE, SUITE #502, COEUR D ALENE, ID 83814
(208) 415-0524
(208) 763-3644
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
176241
NY
2085R0202X
Diagnostic Radiology Physician
Primary
M9521
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000548191
ANTHEM
KY
05
—
010348447
—
VA
01
—
176241
NYS LICENSE #
NY
01
—
3427930000
PASSPORT ADVANTAGE
KY
01
—
50017675
PASSPORT
KY
05
—
7100025670
—
KY
01
—
91826
SIHO
KY
Enumeration date
04/07/2006
Last updated
10/02/2008
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