Organization
STEPHEN R MARANO MD PC
Active
Other names
Eastern Idaho Neurological Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN R MARANO MD (MD)
(208) 522-6930
Entity
Organization
Contact information
Practice address
2375 E SUNNYSIDE RD, STE F, IDAHO FALLS, ID 83404-7579
(208) 522-6930
(208) 523-5342
Mailing address
2375 E SUNNYSIDE RD, STE F, IDAHO FALLS, ID 83404-7579
(208) 522-6930
(208) 523-5342
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
M5076
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010002012
BLUE SHIELD
ID
05
—
000060000
—
ID
01
—
185584800
ASC
—
01
—
57489
BLUE CROSS
ID
Enumeration date
03/05/2007
Last updated
11/18/2008
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