Provider Demographics
NPI:1295000735
Name:FASS, STEVEN JEFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JEFFREY
Last Name:FASS
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 1:1653 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-3791
Mailing Address - Country:US
Mailing Address - Phone:864-306-8533
Mailing Address - Fax:864-306-8513
Practice Address - Street 1:1653 E MAIN ST
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-3791
Practice Address - Country:US
Practice Address - Phone:864-306-8533
Practice Address - Fax:864-306-8513
Is Sole Proprietor?:No
Enumeration Date:2012-03-16
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD 12824208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery