Provider Demographics
NPI:1437829090
Name:STEADMAN, HAROLD JACOB IV
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:JACOB
Last Name:STEADMAN
Suffix:IV
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2014 GOVERNOR NICHOLLS ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70116-2136
Mailing Address - Country:US
Mailing Address - Phone:954-393-9956
Mailing Address - Fax:
Practice Address - Street 1:613 HAMMONDS LN
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MD
Practice Address - Zip Code:21225-3351
Practice Address - Country:US
Practice Address - Phone:410-636-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-15
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDCP008171A225200000X
LAA10853225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant