Provider Demographics
NPI:1396840823
Name:STEEL, EDWARD JOSEPH (DC)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:JOSEPH
Last Name:STEEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 PIERSON DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-6445
Mailing Address - Country:US
Mailing Address - Phone:704-563-5001
Mailing Address - Fax:704-563-5072
Practice Address - Street 1:1409 PIERSON DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-6445
Practice Address - Country:US
Practice Address - Phone:704-563-5001
Practice Address - Fax:704-563-5072
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1381111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0247GOtherBLUE CROSS BLUE SHIELD
NC56-1347650OtherTAX IDENTIFICATION NUMBER
NC8908804Medicaid
NC56-1347650OtherTAX IDENTIFICATION NUMBER
NC8908804Medicaid