Provider Demographics
NPI:1619909769
Name:EBERT, STEVEN MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MICHAEL
Last Name:EBERT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1076 E BETHLEHEM BLVD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-4961
Mailing Address - Country:US
Mailing Address - Phone:304-243-1055
Mailing Address - Fax:304-243-1535
Practice Address - Street 1:2601 NEEDMORE RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-4205
Practice Address - Country:US
Practice Address - Phone:937-277-7246
Practice Address - Fax:937-277-3719
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV899111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation