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NPI Code Detail

MEDICARE: DR. TIMOTHY ALLEN STEENBERGH PH.D.

MEDICARE: DR. TIMOTHY ALLEN STEENBERGH PH.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
1103T00000XPsychologist20041952AIN

General Provider Information

NPI Number : 1780737502
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY ALLEN STEENBERGH PH.D.
Provider Business Mailing Address
First Line : 2105 JAMES DR
Second Line :
City : MARION
State : IN
Zip : 46952
Country : US
Telephone Number : 765-664-3272
Fax Number :
Provider Business Practice Location Address
First Line : 2821 HILLEGAS RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46808-3859
Country : US
Telephone Number : 260-471-1950
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2007
Last Update Date : 07/08/2007

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