Provider Demographics
NPI:1033124805
Name:STEELMAN, SUZANNE (MD)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:STEELMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3822 RIVER ROAD
Mailing Address - Street 2:
Mailing Address - City:PT. PLEASANT
Mailing Address - State:NJ
Mailing Address - Zip Code:08742
Mailing Address - Country:US
Mailing Address - Phone:732-701-4848
Mailing Address - Fax:732-701-1244
Practice Address - Street 1:1900 BROTHER GEENEN WAY
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-7102
Practice Address - Country:US
Practice Address - Phone:941-556-3220
Practice Address - Fax:941-955-8214
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05232500208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5627508Medicaid
NJ5627508Medicaid
NJF35171Medicare UPIN
NJ134630Medicare PIN
NJ134630QTMMedicare ID - Type UnspecifiedPROVIDER NUMBER