Provider Demographics
NPI:1053301119
Name:HARWOOD, STEVEN CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:CHARLES
Last Name:HARWOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5333 MCAULEY DR
Mailing Address - Street 2:SUITE R2009
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-1014
Mailing Address - Country:US
Mailing Address - Phone:734-712-0050
Mailing Address - Fax:734-712-0055
Practice Address - Street 1:5333 MCAULEY DR
Practice Address - Street 2:SUITE R2009
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1014
Practice Address - Country:US
Practice Address - Phone:734-712-0050
Practice Address - Fax:734-712-0055
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301049112208100000X
MISH0491122081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2713436Medicaid
MI250008073OtherRAILROAD MEDICARE
MI250110020OtherBCBS OF MICHIGAN
MI250110020OtherBCBS OF MICHIGAN
MI0N12520007Medicare ID - Type UnspecifiedMEDICARE COMMON PROVIDER
MI2713436Medicaid