Provider Demographics
NPI:1619069754
Name:BATTER, STEPHEN J (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:J
Last Name:BATTER
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 1:12 ELMCREST TER
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-3937
Mailing Address - Country:US
Mailing Address - Phone:203-853-4200
Mailing Address - Fax:203-854-9285
Practice Address - Street 1:12 ELMCREST TER
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-3937
Practice Address - Country:US
Practice Address - Phone:203-853-4200
Practice Address - Fax:203-854-9285
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT036550174400000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001365502Medicaid
CT010036550CT01OtherANTHEM BC BS
CT021108OtherHEALTHNET
CT340016028OtherRAILROAD MEDICARE
CT1429005003OtherCIGNA
CT5473587OtherAETNA
CT036550OtherCONNECTICARE
CTP920783OtherOXFORD
CT021108OtherHEALTHNET
CTG58807Medicare UPIN