MEDICARE: DR. BETTI JO STEELE 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	208000000X	Pediatrics Physician	028654	GA

General Provider Information

NPI Number	:	1407951049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BETTI JO STEELE M.D.

Provider Business Mailing Address
First Line	:	9335 PRESTWICK CLUB DR
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30097-2470
Country	:	US
Telephone Number	:	770-840-0399
Fax Number	:

Provider Business Practice Location Address
First Line	:	1247 DONALD LEE HOLLOWELL PKWY NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-6657
Country	:	US
Telephone Number	:	404-616-2265
Fax Number	:	404-881-0622

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

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	03/07/2023

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