Provider Demographics
NPI:1306864327
Name:LANDERS, STEVEN H (MD, MPH)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:H
Last Name:LANDERS
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 RIVERSIDE AVENUE
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1063
Mailing Address - Country:US
Mailing Address - Phone:732-224-6869
Mailing Address - Fax:732-224-0843
Practice Address - Street 1:176 RIVERSIDE AVENUE
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1063
Practice Address - Country:US
Practice Address - Phone:732-224-6869
Practice Address - Fax:732-224-0843
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-085205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2553893Medicaid
OH7819735OtherAETNA
OH000000530402OtherANTHEM
363733OtherWELLCARE
OHP00226313OtherRAILROAD MEDICARE
OH000000370612OtherANTHEM
000000224403OtherUNISON
737678OtherBUCKEYE
OH7386811Medicare PIN
OH000000370612OtherANTHEM
OHLA4159013Medicare PIN
OH7819735OtherAETNA