Provider Demographics
NPI:1033215769
Name:STEINHAFEL, PETER M (DC)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:M
Last Name:STEINHAFEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:NEKOOSA
Mailing Address - State:WI
Mailing Address - Zip Code:54457-1321
Mailing Address - Country:US
Mailing Address - Phone:715-886-5330
Mailing Address - Fax:715-886-5336
Practice Address - Street 1:317 CEDAR ST
Practice Address - Street 2:
Practice Address - City:NEKOOSA
Practice Address - State:WI
Practice Address - Zip Code:54457-1321
Practice Address - Country:US
Practice Address - Phone:715-886-5330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3516-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38905100Medicaid
52040OtherSECURITY HEALTH PLAN
WI38983200OtherMEDICAID GROUP
WI350052645OtherRAILROAD MEDICARE
WICB3715OtherRAILROAD MEDICARE GROUP