Healthcare Provider Details

I. General information

NPI: 1982965984
Provider Name (Legal Business Name): AMANDA LEA STEINBERGER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2012
Last Update Date: 04/01/2021
Certification Date: 04/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 SIXTH ST SW
CANTON OH
44710-1702
US

IV. Provider business mailing address

PO BOX 72384
CLEVELAND OH
44192-0002
US

V. Phone/Fax

Practice location:
  • Phone: 330-363-2842
  • Fax: 330-580-5536
Mailing address:
  • Phone: 330-363-2842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number20A18608
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: