Provider Demographics
NPI:1780650853
Name:FERGUSON, STEVEN W (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:W
Last Name:FERGUSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:717 STATE STREET
Mailing Address - Street 2:SUITE 16 LL, REGIONAL HEALTH SERVICES INC
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501-1360
Mailing Address - Country:US
Mailing Address - Phone:814-877-7100
Mailing Address - Fax:814-480-7604
Practice Address - Street 1:201 STATE STREET
Practice Address - Street 2:HAMOT FACULTY SPECIALISTS
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16550-0002
Practice Address - Country:US
Practice Address - Phone:814-877-4922
Practice Address - Fax:814-877-3622
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS007021L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001298330002Medicaid
PA0012983330005Medicaid
PA001298330002Medicaid
PA0012983330005Medicaid
PA06805J50Medicare ID - Type Unspecified