Provider Demographics
NPI:1750381398
Name:RIOUX, STEPHEN D (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:D
Last Name:RIOUX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:49 SPRING STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074
Mailing Address - Country:US
Mailing Address - Phone:207-883-1414
Mailing Address - Fax:207-883-1518
Practice Address - Street 1:49 SPRING STREET
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074
Practice Address - Country:US
Practice Address - Phone:207-883-1414
Practice Address - Fax:207-883-1518
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA0122282084P0800X
ME0122282084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME269770099Medicaid
MM069001Medicare PIN
B86382Medicare UPIN
MEMM0690Medicare PIN
MEMM069002Medicare PIN