MEDICARE: DR. ALEC BENTLEY STEADMAN PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	5302042813	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5302042813	OTHER	MI	CONTROLLED SUBSTANCE
2	5302042813	OTHER	MI	PHARMACIST

General Provider Information

NPI Number	:	1164902961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEC BENTLEY STEADMAN PHARMD

Provider Business Mailing Address
First Line	:	1005 E 13 MILE RD
Second Line	:
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-1533
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1005 E 13 MILE RD
Second Line	:
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-1533
Country	:	US
Telephone Number	:	248-307-4900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2018
Last Update Date	:	08/21/2018

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