Provider Demographics
NPI:1528037371
Name:STEELE, EDWARD T (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:T
Last Name:STEELE
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 1:4 GLEN COVE DR
Mailing Address - Street 2:STE 202
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856
Mailing Address - Country:US
Mailing Address - Phone:207-596-9911
Mailing Address - Fax:207-596-9955
Practice Address - Street 1:4 GLEN COVE DR
Practice Address - Street 2:STE 202
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856
Practice Address - Country:US
Practice Address - Phone:207-596-9911
Practice Address - Fax:207-596-9955
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME013143207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E57666Medicare UPIN
MM3790Medicare ID - Type Unspecified