MEDICARE: DR. STEVEN J. DONATELLO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0014X	Interventional Pain Medicine Physician	37794-020	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619950375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN J. DONATELLO M.D.

Provider Business Mailing Address
First Line	:	525 W RIVER WOODS PKWY STE 130
Second Line	:
City	:	GLENDALE
State	:	WI
Zip	:	53212-1010
Country	:	US
Telephone Number	:	414-961-0304
Fax Number	:	414-961-2061

Provider Business Practice Location Address
First Line	:	525 W RIVER WOODS PKWY STE 130
Second Line	:
City	:	GLENDALE
State	:	WI
Zip	:	53212-1010
Country	:	US
Telephone Number	:	414-249-2420
Fax Number	:	414-961-0298

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/26/2005
Last Update Date	:	03/03/2021

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Directions to “ DR. STEVEN J. DONATELLO M.D.” Practice Location

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