Provider Demographics
NPI:1568484889
Name:WINDWER, STEVEN (DC, RPT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:WINDWER
Suffix:
Gender:M
Credentials:DC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HEATHER DR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-5265
Mailing Address - Country:US
Mailing Address - Phone:617-696-9524
Mailing Address - Fax:
Practice Address - Street 1:111 WILLARD ST
Practice Address - Street 2:SUITE GA
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-1200
Practice Address - Country:US
Practice Address - Phone:617-471-4491
Practice Address - Fax:617-984-0636
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5835225100000X
MA1542111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0000029894OtherBCBSRI
MA351168OtherHARVARD PILGRIM HEALTH
MAY66888OtherBCBSMA
MA001542OtherTUFTS HEALTH PLAN
MA0364983Medicaid
MA043158763OtherOXFORD HEALTH
MA412861OtherBCBSRI BLUE CHIP
MA4400336OtherUNITED HEALTHCARE
MA5463OtherFALLON COMMUNITY
MA626126OtherHARVARD PILGRIM HEALTH
MAY36032OtherBCBSMA
MA0009412OtherNEIGHBORHOOD HEALTH PLAN
MA658641OtherCONNECTICARE
MA735153OtherTUFTS HEALTH PLAN
MAY36032OtherBCBSMA