Healthcare Provider Details
I. General information
NPI: 1710969290
Provider Name (Legal Business Name): RICHARD A STEELE JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/18/2005
Last Update Date: 03/04/2020
Certification Date: 03/04/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2001 W 86TH ST
INDIANAPOLIS IN
46260-1902
US
IV. Provider business mailing address
PO BOX 7232 DEPT 165
INDIANAPOLIS IN
46207-7232
US
V. Phone/Fax
- Phone: 866-282-7905
- Fax: 800-731-0751
- Phone: 317-614-9817
- Fax: 317-614-9655
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | 01027576 |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 01027576 |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: