Basic Information
| Provider Information | |||||||||
| NPI: | 1649620741 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STECK | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | BARRETT | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 53081 SCENIC DR | ||||||||
| Address2: | |||||||||
| City: | SHELBY TWP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483162150 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5869809826 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 HARRINGTON ST | ||||||||
| Address2: | |||||||||
| City: | MOUNT CLEMENS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480432920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5864938000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2016 | ||||||||
| LastUpdateDate: | 06/20/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 5101022437 | MI | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.