Provider Demographics
NPI:1114920170
Name:ST. MARIE, STEVEN JOHN (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JOHN
Last Name:ST. MARIE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 FISHER POND RD
Mailing Address - Street 2:
Mailing Address - City:ST ALBANS
Mailing Address - State:VT
Mailing Address - Zip Code:05478-6058
Mailing Address - Country:US
Mailing Address - Phone:802-524-9561
Mailing Address - Fax:802-524-6060
Practice Address - Street 1:128 FISHER POND RD
Practice Address - Street 2:
Practice Address - City:ST ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-6058
Practice Address - Country:US
Practice Address - Phone:802-524-9561
Practice Address - Fax:802-524-6060
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT263152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTP00179932OtherRAILROAD MEDICARE
VTOVNO948Medicaid
VT59V014OtherMVP HEALTHCARE
VT0454604001OtherCIGNA HEALTHCARE
VT28036OtherBLUE CROSS/BLUE SHIELD VT
VT28036OtherBLUE CROSS/BLUE SHIELD VT
VTOVNO948Medicaid
VTP00179932OtherRAILROAD MEDICARE