Provider Demographics
NPI:1861439168
Name:VOPAT, STEVEN BUSTER (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:BUSTER
Last Name:VOPAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 SKYLINE BLVD
Mailing Address - Street 2:
Mailing Address - City:CLOQUET
Mailing Address - State:MN
Mailing Address - Zip Code:55720-3787
Mailing Address - Country:US
Mailing Address - Phone:218-878-7626
Mailing Address - Fax:218-878-7650
Practice Address - Street 1:512 SKYLINE BLVD
Practice Address - Street 2:
Practice Address - City:CLOQUET
Practice Address - State:MN
Practice Address - Zip Code:55720-3787
Practice Address - Country:US
Practice Address - Phone:218-878-7626
Practice Address - Fax:218-878-7650
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN38760208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNF00535Medicare UPIN