Individual
ELPIDIO G MARIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1410 N 4 STREET, CLINTON, IA 52732
(563) 242-5316
Mailing address
PO BOX 0361, CLINTON, IA 52733-0361
(563) 242-5316
(563) 242-3128
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
21940
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0307512
—
IA
01
—
19344
MIDLANDS CHOICE
—
01
—
31967
BCBS
IA
01
—
P00186005
RR MEDICARE PIN
IA
Enumeration date
01/18/2006
Last updated
04/11/2008
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