Healthcare Provider Details

I. General information

NPI: 1588083570
Provider Name (Legal Business Name): IAN HOGAN STEELE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 N MAYFAIR RD
MILWAUKEE WI
53226-3462
US

IV. Provider business mailing address

1155 N MAYFAIR RD
MILWAUKEE WI
53226-3462
US

V. Phone/Fax

Practice location:
  • Phone: 414-955-8990
  • Fax: 414-955-6282
Mailing address:
  • Phone: 414-955-8990
  • Fax: 414-955-6282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number30716
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number66954
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number68006
License Number StateAZ
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number71840
License Number StateWI
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2022-03083
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: