Provider Demographics
NPI:1235389362
Name:GLEN COVE INTERNAL MEDICINE, LLC
Entity Type:Organization
Organization Name:GLEN COVE INTERNAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:T
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-273-3177
Mailing Address - Street 1:4 GLEN COVE DR STE 202
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856-4238
Mailing Address - Country:US
Mailing Address - Phone:207-273-3177
Mailing Address - Fax:207-273-4544
Practice Address - Street 1:4 GLEN COVE DR STE 202
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856-4238
Practice Address - Country:US
Practice Address - Phone:207-273-3177
Practice Address - Fax:207-273-4544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty