Provider Demographics
NPI:1235174657
Name:STEINLAGE, JOHN PAUL (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PAUL
Last Name:STEINLAGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 E NAWADA ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-5271
Mailing Address - Country:US
Mailing Address - Phone:920-810-2372
Mailing Address - Fax:855-318-1345
Practice Address - Street 1:CHC OF WISCONSIN
Practice Address - Street 2:1120 E NAWADA ST
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-5271
Practice Address - Country:US
Practice Address - Phone:920-810-2372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI38129207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32368400Medicaid
WI32368400Medicaid