Provider Demographics
NPI:1508858192
Name:PEINE, STEVEN DEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:DEAN
Last Name:PEINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6460 MEDICAL CENTER ST., SUITE 350
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-8637
Mailing Address - Country:US
Mailing Address - Phone:702-255-6647
Mailing Address - Fax:702-933-1444
Practice Address - Street 1:6460 MEDICAL CENTER ST., SUITE 350
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-8637
Practice Address - Country:US
Practice Address - Phone:702-255-6647
Practice Address - Fax:702-933-1444
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV9723207Q00000X, 207N00000X
NV17074207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1508858192Medicaid