Basic Information
| Provider Information | |||||||||
| NPI: | 1720018245 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STEINKE | ||||||||
| FirstName: | EMIL | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 6001 | ||||||||
| Address2: | |||||||||
| City: | FARGO | ||||||||
| State: | ND | ||||||||
| PostalCode: | 581086001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7013643300 | ||||||||
| FaxNumber: | 7013648906 | ||||||||
| Practice Location | |||||||||
| Address1: | 420 CENTER AVE | ||||||||
| Address2: | |||||||||
| City: | MOORHEAD | ||||||||
| State: | MN | ||||||||
| PostalCode: | 565601957 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2183646800 | ||||||||
| FaxNumber: | 2182339267 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2006 | ||||||||
| LastUpdateDate: | 08/15/2011 | ||||||||
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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 | 207Q00000X | 34349 | MN | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 6055 | ND | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 10636 | 01 | ND | NDBS # | OTHER | 13391 | 01 | MN | SIOUX VALLEY # | OTHER | 0105979 | 01 | ND | MEDICA # | OTHER | 0118706 | 01 | ND | MEDICA # | OTHER | 16609 | 05 | MN | MEDICAID | 80701ST | 01 | ND | MNBS # | OTHER | 367205100 | 05 | MN | MEDICAID | 915443 | 01 | MN | AMERICA'S PPO/ARAZ # | OTHER | DA9011015631 | 01 | ND | PREFERRED ONE # | OTHER | HP19564 | 01 | MN | HEALTHPARTNERS # | OTHER | 0105978 | 01 | MN | MEDICA # | OTHER | 126800 | 01 | MN | UCARE # | OTHER | 80528ST | 01 | MN | MNBS # | OTHER | 80700ST | 01 | ND | MNBS # | OTHER | MN100036 | 01 | MN | LHS # | OTHER | 80699ST | 01 | ND | MNBS # | OTHER | B56858 | 01 | UPIN # | OTHER |