Provider Demographics
NPI:1609630219
Name:STEELAND, AVERY L
Entity Type:Individual
Prefix:
First Name:AVERY
Middle Name:L
Last Name:STEELAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2813 PARKERS LANDING RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-6743
Mailing Address - Country:US
Mailing Address - Phone:248-499-0765
Mailing Address - Fax:
Practice Address - Street 1:2813 PARKERS LANDING RD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-6743
Practice Address - Country:US
Practice Address - Phone:248-499-0765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant