Provider Demographics
NPI:1467488221
Name:STEINWALD, PAUL M (MD)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:M
Last Name:STEINWALD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 HERITAGE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3673
Mailing Address - Country:US
Mailing Address - Phone:303-278-2600
Mailing Address - Fax:303-278-4841
Practice Address - Street 1:725 HERITAGE RD STE 100
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-3673
Practice Address - Country:US
Practice Address - Phone:303-278-2600
Practice Address - Fax:303-278-4841
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-102957174400000X
CODR0054327208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL791243075Medicare UPIN
ILH26532Medicare UPIN
IL595570Medicare ID - Type Unspecified