Healthcare Provider Details

I. General information

NPI: 1063595817
Provider Name (Legal Business Name): RICHARD STEINMETZ DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 04/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 FOREST AVE STE 102
PORTLAND ME
04103-3357
US

IV. Provider business mailing address

980 FOREST AVE STE 102
PORTLAND ME
04103-3357
US

V. Phone/Fax

Practice location:
  • Phone: 207-854-0300
  • Fax: 207-856-2807
Mailing address:
  • Phone: 207-854-0300
  • Fax: 207-856-2807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberPOD167
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: