MEDICARE: CRAIG G STEINER MD

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	207Q00000X	Family Medicine Physician	11390481-1205	UT
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207Q00000X	Family Medicine Physician	M-15687	ID

General Provider Information

NPI Number	:	1710477500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRAIG G STEINER MD

Provider Business Mailing Address
First Line	:	3820 CRESTWOOD LN
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-4979
Country	:	US
Telephone Number	:	208-552-7700
Fax Number	:	208-552-1786

Provider Business Practice Location Address
First Line	:	3820 CRESTWOOD LN
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-4979
Country	:	US
Telephone Number	:	208-552-7700
Fax Number	:	208-552-1786

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

Provider Enumeration Date	:	05/16/2018
Last Update Date	:	04/24/2024

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