Healthcare Provider Details
I. General information
NPI: 1629067558
Provider Name (Legal Business Name): ROBERT STEINER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/13/2005
Last Update Date: 01/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3401 N BROAD ST 1ST FLR PARK AVE PAVILION
PHILADELPHIA PA
19140-5103
US
IV. Provider business mailing address
PO BOX 827783
PHILADELPHIA PA
19182-7783
US
V. Phone/Fax
- Phone: 215-707-7237
- Fax: 215-707-9389
- Phone: 215-707-8561
- Fax: 215-707-3677
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0904X |
| Taxonomy | Nuclear Radiology Physician |
| License Number | MD008181E |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | MD008181E |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: