Provider Demographics
NPI:1780680736
Name:RAY, STEVEN A (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:A
Last Name:RAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:865 LINCOLN RD
Mailing Address - Street 2:STE L10
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4159
Mailing Address - Country:US
Mailing Address - Phone:563-355-9191
Mailing Address - Fax:563-355-3419
Practice Address - Street 1:2560 24TH ST
Practice Address - Street 2:STE 202
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-5390
Practice Address - Country:US
Practice Address - Phone:309-794-0590
Practice Address - Fax:309-779-3084
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2021-04-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036-072047207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
020379OtherHEALTH ALLIANCE
4796890015OtherDMERC
20076OtherIOWA HEALTH SOLUTIONS
97781OtherWELLMARK BC/BS
IA0151OtherJOHN DEERE HEALTH PLAN
IL036072047Medicaid
97781OtherWELLMARK BC/BS
IA0151OtherJOHN DEERE HEALTH PLAN
L86110Medicare PIN