Provider Demographics
NPI:1588635270
Name:STEIDL, DANIEL L (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:L
Last Name:STEIDL
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 1:600 PORTAGE TRL STE D
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-3055
Mailing Address - Country:US
Mailing Address - Phone:330-928-4427
Mailing Address - Fax:330-928-9957
Practice Address - Street 1:600 PORTAGE TRL STE D
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-3055
Practice Address - Country:US
Practice Address - Phone:330-928-4427
Practice Address - Fax:330-928-9957
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35049293207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0539493OtherMEDICARE ID
OH0538270Medicaid
OH9302721Medicare PIN
OH0539493OtherMEDICARE ID