Healthcare Provider Details

I. General information

NPI: 1316036189
Provider Name (Legal Business Name): STEPHANIE MARIE ARAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE MARIE-HELENE CHICK, BROWER

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 S 7TH ST
ST MARIES ID
83861-1803
US

IV. Provider business mailing address

229 S 7TH ST
ST MARIES ID
83861-1803
US

V. Phone/Fax

Practice location:
  • Phone: 208-245-5551
  • Fax: 208-245-5246
Mailing address:
  • Phone: 208-245-5551
  • Fax: 208-245-2262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberM-16586
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberM-16586
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberM-16586
License Number StateID
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD60225647
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: