Healthcare Provider Details

I. General information

NPI: 1619696317
Provider Name (Legal Business Name): STEADYHAND MEDICAL GROUP FL PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2022
Last Update Date: 08/25/2022
Certification Date: 08/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 MARKET ST STE 1005
PHILADELPHIA PA
19103-3920
US

IV. Provider business mailing address

1700 MARKET ST STE 1005
PHILADELPHIA PA
19103-3920
US

V. Phone/Fax

Practice location:
  • Phone: 844-904-1713
  • Fax: 844-909-4644
Mailing address:
  • Phone: 844-904-1713
  • Fax: 844-909-4644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: KAMARR BROWN
Title or Position: AUTHORIZED PERSON
Credential:
Phone: 215-709-5670