Healthcare Provider Details

I. General information

NPI: 1164529061
Provider Name (Legal Business Name): CHARLES E STEINER, DO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 03/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2364 BLIZZARD LN STE A
ALBANY OH
45710-9287
US

IV. Provider business mailing address

2364 BLIZZARD LN STE A
ALBANY OH
45710-9287
US

V. Phone/Fax

Practice location:
  • Phone: 740-566-4720
  • Fax: 740-566-4721
Mailing address:
  • Phone: 740-566-4720
  • Fax: 740-566-4721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number34006505S
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34006505S
License Number StateOH

VIII. Authorized Official

Name: DR. CHARLES E STEINER
Title or Position: PRESIDENT
Credential: DO
Phone: 740-566-4720