Provider Demographics
NPI:1760541833
Name:STEELE, CLINT MCDONALD (DC)
Entity Type:Individual
Prefix:DR
First Name:CLINT
Middle Name:MCDONALD
Last Name:STEELE
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 1:675 MAIN ST
Mailing Address - Street 2:SUITE 18
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-5802
Mailing Address - Country:US
Mailing Address - Phone:207-782-1171
Mailing Address - Fax:207-782-6176
Practice Address - Street 1:675 MAIN ST
Practice Address - Street 2:SUITE 18
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-5802
Practice Address - Country:US
Practice Address - Phone:207-782-1171
Practice Address - Fax:207-782-6176
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR913111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEM23107OtherCIGNA HMO
ME018173OtherANTHEM BLUE CROSS AND BLU
MEME0420OtherHARVARD HEALTH CARE
ME4404011OtherUNITED HEALTHCARE
MEME0420OtherHARVARD HEALTH CARE
MESTMM5042Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL NO.
ME4404011OtherUNITED HEALTHCARE