Healthcare Provider Details

I. General information

NPI: 1770615338
Provider Name (Legal Business Name): STEVEN EDWARD CONKEL M.D., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 04/07/2021
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 WARDER ST SUITE 220
SPRINGFIELD OH
45504-2500
US

IV. Provider business mailing address

30 WARDER ST SUITE 220
SPRINGFIELD OH
45504-2500
US

V. Phone/Fax

Practice location:
  • Phone: 937-399-7021
  • Fax: 937-399-0697
Mailing address:
  • Phone: 937-399-7021
  • Fax: 937-399-0697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number85721
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: