Provider Demographics
NPI:1760589089
Name:OLDER, STEVEN ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ANTHONY
Last Name:OLDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3534 W LAKE DR
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-9530
Mailing Address - Country:US
Mailing Address - Phone:706-210-8751
Mailing Address - Fax:
Practice Address - Street 1:300 W HOSPITAL DR
Practice Address - Street 2:DWIGHT DAVID EISENHOWER ARMY MEDICAL CENTER
Practice Address - City:FT. GORDON
Practice Address - State:GA
Practice Address - Zip Code:30905-5650
Practice Address - Country:US
Practice Address - Phone:706-787-6462
Practice Address - Fax:706-787-0005
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG7093207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology