Provider Demographics
NPI:1093764706
Name:VERBRIDGE, STEVEN J (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:VERBRIDGE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4602 DEPT
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60122-0021
Mailing Address - Country:US
Mailing Address - Phone:906-225-7725
Mailing Address - Fax:906-225-4537
Practice Address - Street 1:420 W MAGNETIC ST
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-2711
Practice Address - Country:US
Practice Address - Phone:906-225-3561
Practice Address - Fax:906-225-3370
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101015286207P00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP00353406OtherRAILROAD MEDICARE
MI4902559Medicaid
MISV015286OtherBCBSM
MIP00353406OtherRAILROAD MEDICARE