Provider Demographics
NPI:1851310411
Name:COENEN, STEVEN RONALD (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RONALD
Last Name:COENEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:STEVEN
Other - Middle Name:RONALD
Other - Last Name:COENEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:N415 FOXWOOD DR
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-9101
Mailing Address - Country:US
Mailing Address - Phone:920-831-0070
Mailing Address - Fax:
Practice Address - Street 1:10 TRIPARKWAY
Practice Address - Street 2:VA CLINIC
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914
Practice Address - Country:US
Practice Address - Phone:920-831-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI30785-020207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine