Provider Demographics
NPI:1376531079
Name:RICE, STEVEN WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:WILLIAM
Last Name:RICE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2055 15TH ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1747
Mailing Address - Country:US
Mailing Address - Phone:320-251-1432
Mailing Address - Fax:320-251-7122
Practice Address - Street 1:2055 15TH ST N
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-1747
Practice Address - Country:US
Practice Address - Phone:320-251-1432
Practice Address - Fax:320-251-7122
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN28981207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0822038OtherMEDICA
MN00884RIOtherBLUE CROSS
180011540OtherRAILROAD MEDICARE
MN303818100Medicaid
MN303818100Medicaid
D75419Medicare UPIN