Provider Demographics
NPI:1518058650
Name:STEEN, ERIC CHRISTIAN (DO)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:CHRISTIAN
Last Name:STEEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2460 LEE HWY N
Mailing Address - Street 2:SUITE 4
Mailing Address - City:PULASKI
Mailing Address - State:VA
Mailing Address - Zip Code:24301-2335
Mailing Address - Country:US
Mailing Address - Phone:540-980-9660
Mailing Address - Fax:
Practice Address - Street 1:2460 LEE HWY N
Practice Address - Street 2:SUITE 4
Practice Address - City:PULASKI
Practice Address - State:VA
Practice Address - Zip Code:24301-2335
Practice Address - Country:US
Practice Address - Phone:540-980-9660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102201921208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010360722Medicaid
VA1518058650Medicaid
VAP00398133OtherRR MEDICARE
VAP00398133OtherRR MEDICARE
VA1518058650Medicaid