Provider Demographics
NPI:1720018245
Name:STEINKE, EMIL B (MD)
Entity Type:Individual
Prefix:
First Name:EMIL
Middle Name:B
Last Name:STEINKE
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:PO BOX 6001
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58108-6001
Mailing Address - Country:US
Mailing Address - Phone:701-364-3300
Mailing Address - Fax:701-364-8906
Practice Address - Street 1:420 CENTER AVE
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-1957
Practice Address - Country:US
Practice Address - Phone:218-364-6800
Practice Address - Fax:218-233-9267
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN34349207Q00000X
ND6055207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND10636OtherNDBS #
MN13391OtherSIOUX VALLEY #
ND0105979OtherMEDICA #
ND0118706OtherMEDICA #
MN16609Medicaid
ND80701STOtherMNBS #
MN367205100Medicaid
MN915443OtherAMERICA'S PPO/ARAZ #
NDDA9011015631OtherPREFERRED ONE #
MNHP19564OtherHEALTHPARTNERS #
MN0105978OtherMEDICA #
MN126800OtherUCARE #
MN80528STOtherMNBS #
ND80700STOtherMNBS #
MNMN100036OtherLHS #
ND80699STOtherMNBS #
B56858OtherUPIN #
MNHP19564OtherHEALTHPARTNERS #
ND10636Medicare UPIN
MN089004381Medicare ID - Type UnspecifiedMN MEDICARE #