Basic Information
Provider Information
NPI: 1841297603
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STEINBERG
FirstName: MICHAEL
MiddleName: P
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 263 FARMINGTON AVE
Address2: PROVIDER ENROLLMENT
City: FARMINGTON
State: CT
PostalCode: 060302212
CountryCode: US
TelephoneNumber: 8606797503
FaxNumber: 8606791610
Practice Location
Address1: 263 FARMINGTON AVE
Address2:  
City: FARMINGTON
State: CT
PostalCode: 060300001
CountryCode: US
TelephoneNumber: 8606794477
FaxNumber: 8606794474
Other Information
ProviderEnumerationDate: 07/07/2005
LastUpdateDate: 09/29/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X035976CTY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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