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General NPI Number Information
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NPI Number | 1114095817
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Entity Type | Organization
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Legal Business Name | STEVEN A PORTNEY, MD, PC
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 10/15/2007
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Provider Practice Location Address
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Address Line | 22250 PROVIDENCE DR SUITE #200
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City | SOUTHFIELD
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State | MI
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Zip | 48075-6210
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Country | US
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Telephone | 248-552-0242
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Fax | 248-552-8418
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Provider Business Mailing Address
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Address Line | 22250 PROVIDENCE DR SUITE #200
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City | SOUTHFIELD
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State | MI
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Zip | 48075-6210
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Country | US
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Telephone | 248-552-0242
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Fax | 248-552-8418
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEVEN A PORTNEY
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Credential | MD, PC
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Telephone | 248-552-0242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | SP057396
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License Number State | MN
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