Provider Demographics
NPI:1144416900
Name:KUBEL, STEVEN R (DPM)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:R
Last Name:KUBEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 SOUTH NEVADA STREET
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-4287
Mailing Address - Country:US
Mailing Address - Phone:775-887-0400
Mailing Address - Fax:775-887-0660
Practice Address - Street 1:212 SOUTH NEVADA STREET
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-4287
Practice Address - Country:US
Practice Address - Phone:775-887-0400
Practice Address - Fax:775-887-0660
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-14
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9302213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV38638Medicare PIN
NVT11248Medicare UPIN