Healthcare Provider Details

I. General information

NPI: 1407827793
Provider Name (Legal Business Name): SCOTT RUSSELL STEELE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 10/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE A30
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE A30
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-4747
  • Fax:
Mailing address:
  • Phone: 216-444-4747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number01052143A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD00047574
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number35-125615
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: