Provider Demographics
NPI:1508199035
Name:MATEIKO, STEVEN FRANCIS (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:FRANCIS
Last Name:MATEIKO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4059 NC HIGHWAY 105 S
Mailing Address - Street 2:
Mailing Address - City:SUGAR MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28604-8629
Mailing Address - Country:US
Mailing Address - Phone:828-898-8971
Mailing Address - Fax:828-898-5265
Practice Address - Street 1:4059 NC HIGHWAY 105 S
Practice Address - Street 2:
Practice Address - City:SUGAR MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28604-8629
Practice Address - Country:US
Practice Address - Phone:828-898-8971
Practice Address - Fax:828-898-5265
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14775183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0065128Medicaid