Provider Demographics
NPI:1386642726
Name:FARRELL, STEVEN J (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:FARRELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3355 GLENDALE AVE 3RD FL
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2426
Mailing Address - Country:US
Mailing Address - Phone:419-383-5000
Mailing Address - Fax:419-383-3398
Practice Address - Street 1:3065 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2570
Practice Address - Country:US
Practice Address - Phone:419-383-5000
Practice Address - Fax:419-383-3398
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2018-01-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35070499208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2011263Medicaid
OH2011263Medicaid
G32112Medicare UPIN