Provider Demographics
NPI:1558438226
Name:GEORGE, STEVEN EDWARD (MD)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:EDWARD
Last Name:GEORGE
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 1:2817 REILLY ROAD
Mailing Address - Street 2:
Mailing Address - City:FT BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28310
Mailing Address - Country:US
Mailing Address - Phone:910-907-8176
Mailing Address - Fax:910-907-7463
Practice Address - Street 1:2817 REILLY ROAD
Practice Address - Street 2:
Practice Address - City:FT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310
Practice Address - Country:US
Practice Address - Phone:910-907-8176
Practice Address - Fax:910-907-7463
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16766207V00000X
NC9601613207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL115804Medicaid
MS06302268Medicaid
AL73020227OtherBCBS OF AL
MS06302268Medicaid
302I168886Medicare PIN
AL73020227OtherBCBS OF AL