Basic Information
Provider Information | |||||||||
NPI: | 1518903863 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | STEINES | ||||||||
FirstName: | WILLIAM | ||||||||
MiddleName: | J | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | STEINES | ||||||||
OtherFirstName: | WILLIAM | ||||||||
OtherMiddleName: | J | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: | 5 | ||||||||
Mailing Information | |||||||||
Address1: | 10700 E GEDDES AVE | ||||||||
Address2: | NO 200 | ||||||||
City: | ENGLEWOOD | ||||||||
State: | CO | ||||||||
PostalCode: | 801123800 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: |   | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 501 E HAMPDEN AVE | ||||||||
Address2: |   | ||||||||
City: | ENGLEWOOD | ||||||||
State: | CO | ||||||||
PostalCode: | 801132702 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3037619190 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/22/2006 | ||||||||
LastUpdateDate: | 09/18/2012 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 18887 | CO | Y |   | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
ID | Type | State | Issuer | Description | 84-059792913 | 05 | NE |   | MEDICAID | 01188879 | 05 | CO |   | MEDICAID | 053210301 | 01 | TX | TX MEDICAID | OTHER | 117327800 | 01 | WY | WY MEDICAID | OTHER | 300090361 | 01 | CO | RR DIA MCRE | OTHER | 920422 | 01 | AZ | AZ MEDICAID | OTHER | 104699372 | 01 | MI | MI MEDICAID | OTHER | 300090362 | 01 | CO | RR MIC MCRE | OTHER | XPY201216 | 01 | CA | CA MEDICAID | OTHER | 200424780A | 01 | KS | KS MEDICAID | OTHER | 02300663 | 01 | NY | NY MEDICAID | OTHER | 300049088 | 01 | CO | RR RIA MCRE | OTHER |