Healthcare Provider Details

I. General information

NPI: 1598128985
Provider Name (Legal Business Name): ROBERT BLAKE STEELE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 S 1100 E
AMERICAN FORK UT
84003-2817
US

IV. Provider business mailing address

148 S 1100 E
AMERICAN FORK UT
84003-2817
US

V. Phone/Fax

Practice location:
  • Phone: 386-336-7461
  • Fax: 385-336-7462
Mailing address:
  • Phone: 386-336-7461
  • Fax: 385-336-7462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD470518
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number12675993-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: