Healthcare Provider Details

I. General information

NPI: 1568990075
Provider Name (Legal Business Name): STEVEN NEUBAUER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2017
Last Update Date: 07/02/2022
Certification Date: 07/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8423 MARKET ST STE 205
BOARDMAN OH
44512-6778
US

IV. Provider business mailing address

835 PEARSON CIR UNIT 3
YOUNGSTOWN OH
44512-5769
US

V. Phone/Fax

Practice location:
  • Phone: 330-729-3125
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number34.015897
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: