Provider Demographics
NPI:1396838686
Name:DAVID M STIEBER MD FACC INC
Entity Type:Organization
Organization Name:DAVID M STIEBER MD FACC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:STIEBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-989-8418
Mailing Address - Street 1:PO BOX 6037
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33482-6037
Mailing Address - Country:US
Mailing Address - Phone:239-989-8418
Mailing Address - Fax:561-807-7351
Practice Address - Street 1:5352 LINTON BLVD
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6514
Practice Address - Country:US
Practice Address - Phone:239-989-8418
Practice Address - Fax:561-807-7351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG39762207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G397620Medicaid
CAG39762Medicare ID - Type Unspecified
A47950Medicare UPIN