Healthcare Provider Details

I. General information

NPI: 1740713320
Provider Name (Legal Business Name): MARK D STEUERWALD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2017
Last Update Date: 08/30/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 HOSPITAL PLZ STE 502
STAMFORD CT
06902-3602
US

IV. Provider business mailing address

29 HOSPITAL PLZ STE 502
STAMFORD CT
06902-3602
US

V. Phone/Fax

Practice location:
  • Phone: 203-348-7410
  • Fax: 203-961-8488
Mailing address:
  • Phone: 203-348-7410
  • Fax: 203-961-8488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number73505
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: