Healthcare Provider Details

I. General information

NPI: 1164678298
Provider Name (Legal Business Name): BRADY SCOTT STEINECK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2008
Last Update Date: 04/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1302 W MAIN ST SUITE A
LOUISVILLE OH
44641-1114
US

IV. Provider business mailing address

1302 W MAIN ST SUITE A
LOUISVILLE OH
44641-1114
US

V. Phone/Fax

Practice location:
  • Phone: 330-875-5544
  • Fax: 330-875-8150
Mailing address:
  • Phone: 330-875-5544
  • Fax: 330-875-8150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35096492
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: