Provider Demographics
NPI:1144214537
Name:NUERNBERGER, STEVEN PAUL (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:PAUL
Last Name:NUERNBERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 BRIARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62234-5213
Mailing Address - Country:US
Mailing Address - Phone:618-345-8653
Mailing Address - Fax:618-345-2663
Practice Address - Street 1:ANDERSON HOSPITAL LABORATORY
Practice Address - Street 2:RT 162
Practice Address - City:MARYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62062-1000
Practice Address - Country:US
Practice Address - Phone:618-288-6298
Practice Address - Fax:618-288-3346
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO33429207ZP0102X
MT10671207ZP0102X
IL207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E18789Medicare UPIN