Provider Demographics
NPI:1437471547
Name:MAX M STEELE MD PC
Entity Type:Organization
Organization Name:MAX M STEELE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MAX
Authorized Official - Middle Name:M
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-408-2999
Mailing Address - Street 1:370 9TH AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84103-3186
Mailing Address - Country:US
Mailing Address - Phone:801-408-2999
Mailing Address - Fax:801-236-7810
Practice Address - Street 1:370 9TH AVE
Practice Address - Street 2:STE 101
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84103-3186
Practice Address - Country:US
Practice Address - Phone:801-408-2999
Practice Address - Fax:801-236-7810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1576388905207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU000000326Medicare PIN