Provider Demographics
NPI:1871673764
Name:STEINBACH, ANDREW MAXWELL (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:MAXWELL
Last Name:STEINBACH
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 1:12 EAST MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:13733
Mailing Address - Country:US
Mailing Address - Phone:607-967-2071
Mailing Address - Fax:
Practice Address - Street 1:12 EAST MAIN ST
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:NY
Practice Address - Zip Code:13733
Practice Address - Country:US
Practice Address - Phone:607-967-2071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1577641207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00853383Medicaid
B82503Medicare UPIN
39642BMedicare ID - Type Unspecified