Provider Demographics
NPI:1477504868
Name:KOENIG, STEVEN B (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:B
Last Name:KOENIG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:925 N 87TH ST
Mailing Address - Street 2:THE EYE INSTITUTE
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4812
Mailing Address - Country:US
Mailing Address - Phone:414-456-2020
Mailing Address - Fax:414-456-6300
Practice Address - Street 1:925 N 87TH ST
Practice Address - Street 2:THE EYE INSTITUTE
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4812
Practice Address - Country:US
Practice Address - Phone:414-456-2020
Practice Address - Fax:414-456-6300
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2014-03-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI25324207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
002000122SOtherHUMANA
WI1477504868Medicaid
180018689OtherRAILROAD MEDICARE
B54243Medicare UPIN
WI1477504868Medicaid
WI068373601Medicare PIN