Provider Demographics
NPI:1265492953
Name:COKER, STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:COKER
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:PO BOX 11271
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4003
Mailing Address - Country:US
Mailing Address - Phone:877-848-1457
Mailing Address - Fax:
Practice Address - Street 1:1590 FREEDOM BLVD
Practice Address - Street 2:STE. B
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-6071
Practice Address - Country:US
Practice Address - Phone:843-665-9581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7337207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4255293OtherAETNA
NC8905336Medicaid
SCE2869OtherMEDCOST
SC073379Medicaid
SC470890494OtherSTANDARD TAX ID
SC0700476OtherCAROLINA CARE PLAN
SCP00235580Medicare ID - Type UnspecifiedRAILROAD MEDICARE
SC0700476OtherCAROLINA CARE PLAN
SCE2869OtherMEDCOST
SCB92037Medicare UPIN