Provider Demographics
NPI:1790056927
Name:DAVID M. STIEBER MD FACC, INC
Entity Type:Organization
Organization Name:DAVID M. STIEBER MD FACC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:STIEBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-347-9149
Mailing Address - Street 1:PO BOX 72382
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99707-2382
Mailing Address - Country:US
Mailing Address - Phone:907-374-0432
Mailing Address - Fax:907-328-2202
Practice Address - Street 1:1626 30TH AVE STE 204
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-7423
Practice Address - Country:US
Practice Address - Phone:907-374-0432
Practice Address - Fax:907-328-2202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-19
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK7024207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty