Provider Demographics
NPI:1740214949
Name:STEPHEN H MASCIO DO
Entity type:Organization
Organization Name:STEPHEN H MASCIO DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:MASCIO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:304-527-1670
Mailing Address - Street 1:1417 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FOLLANSBEE
Mailing Address - State:WV
Mailing Address - Zip Code:26037-1217
Mailing Address - Country:US
Mailing Address - Phone:304-524-1670
Mailing Address - Fax:304-527-1672
Practice Address - Street 1:1417 MAIN ST
Practice Address - Street 2:
Practice Address - City:FOLLANSBEE
Practice Address - State:WV
Practice Address - Zip Code:26037-1217
Practice Address - Country:US
Practice Address - Phone:304-524-1670
Practice Address - Fax:304-527-1672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1439207Q00000X
OH34006186207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000319438OtherANTHEM BCBS
000000117353OtherUNISOM HEALTH PLAN
OH000000117353OtherTHREE RIVERS PROV
WV001705867OtherMSBCBS
DC8576OtherRRW MEDICARE
OHG01439AOtherMEDICARE PLUS HEALTHPLAN
OH0242277Medicaid
205314OtherCARELINK
205314OtherHEALTH AMERICA
PA104698OtherUPMC
7716087001OtherCIGNA
205314OtherHEALTH ASSURANCE
205314OtherADVANTRA FREEDOM
205314OtherCARELINK ADVANTRA
279582OtherMAMSI
WV3003385000Medicaid
OHG01439AOtherHEALTH PLAN MANAGED WORKER'S COMPENSATION PROGRAM
PA001464699OtherHIGHMARK BLUE CROSS
WV1060493OtherWORKER'S COMPENSATION
OHG01439AOtherTHE HEALTH PLAN
OH=========026OtherCARESOURCE
WV001705867OtherMSBCBS
PA104698OtherUPMC
OH=========00OtherCOMPMANAGEMENT
OHG01439AOtherMEDICARE PLUS HEALTHPLAN
OH000000117353OtherTHREE RIVERS PROV
OHG01439AOtherHEALTH PLAN MANAGED WORKER'S COMPENSATION PROGRAM
7716087001OtherCIGNA