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General NPI Number Information
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NPI Number | 1548296395
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Entity Type | Individual
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Provider Name | STEVEN STREET DO
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Gender | Male
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 06/03/2008
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Provider Practice Location Address
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Address Line | 1601 E BROADWAY LOWER LEVEL
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City | COLUMBIA
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State | MO
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Zip | 65201
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Country | US
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Telephone | 573-815-2700
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Fax | 573-815-3693
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Provider Business Mailing Address
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Address Line | PO BOX 7096
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City | STOCKTON
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State | CA
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Zip | 95267
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Country | US
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Telephone | 209-956-7725
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Fax | 209-956-7733
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 102907
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License Number State | MO
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