Individual
STEVEN WAYNE ETOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3 AUDUBON PLAZA DR STE 560, LOUISVILLE, KY 40217-1376
(502) 636-8004
(502) 636-8384
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
28801
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000497079
ANTHEM - CTS
—
01
—
083219
SIHO - CTS
—
05
—
200182720
—
IN
01
—
2834557000
PAD - CTS 560
—
01
—
50014460
PASSPORT - CTS 560
—
05
—
64288012
—
KY
01
—
P00368248
RRMCR - CTS
KY
Enumeration date
11/07/2006
Last updated
01/12/2021
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