Provider Demographics
NPI:1508973843
Name:BATUELLO, STEPHEN GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:GEORGE
Last Name:BATUELLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14300 ORCHARD PKWY
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80023-9206
Mailing Address - Country:US
Mailing Address - Phone:720-321-8410
Mailing Address - Fax:720-321-8411
Practice Address - Street 1:14300 ORCHARD PKWY
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80023-9206
Practice Address - Country:US
Practice Address - Phone:720-321-8410
Practice Address - Fax:720-321-8411
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE32001207Y00000X
CO32676207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
468298Medicare ID - Type Unspecified