Provider Demographics
NPI:1093712507
Name:STEELE, REBECCA M (DO)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:M
Last Name:STEELE
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1640 FORT ST
Mailing Address - Street 2:SUITE D ATTN DENISE
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-2040
Mailing Address - Country:US
Mailing Address - Phone:734-391-3057
Mailing Address - Fax:734-391-3052
Practice Address - Street 1:1640 FORT ST
Practice Address - Street 2:SUITE D
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-2040
Practice Address - Country:US
Practice Address - Phone:734-671-6741
Practice Address - Fax:734-671-1038
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2017-02-22
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Provider Licenses
StateLicense IDTaxonomies
MI5101012582207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0H27501OtherBLUE CROSS
1841564788OtherGROUP NPI HENRY FORD WYANDOTTE
MIG54996Medicare UPIN
MIMI5491015Medicare PIN