Provider Demographics
NPI:1104201631
Name:STEINKRUGER, MICHAEL
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:STEINKRUGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 S HIGH ST
Mailing Address - Street 2:
Mailing Address - City:GREENE
Mailing Address - State:IA
Mailing Address - Zip Code:50636-9437
Mailing Address - Country:US
Mailing Address - Phone:641-823-4531
Mailing Address - Fax:
Practice Address - Street 1:108 S HIGH ST
Practice Address - Street 2:
Practice Address - City:GREENE
Practice Address - State:IA
Practice Address - Zip Code:50636-9437
Practice Address - Country:US
Practice Address - Phone:641-823-4531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01591314000000X
IA314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA165356Medicare UPIN