Provider Demographics
NPI:1578537056
Name:MCDONALD, STEVEN A (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:A
Last Name:MCDONALD
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 1:1530 N 7TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47807-1061
Mailing Address - Country:US
Mailing Address - Phone:812-238-7631
Mailing Address - Fax:812-238-7003
Practice Address - Street 1:1530 N 7TH ST STE 200
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47807
Practice Address - Country:US
Practice Address - Phone:812-238-7631
Practice Address - Fax:812-238-7003
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01027543A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN080151014OtherRAILROAD MEDICARE
IN100252290Medicaid
IN941090X1Medicare PIN
INE03877Medicare UPIN
IN080151014OtherRAILROAD MEDICARE
IN162200Medicare ID - Type Unspecified