Provider Demographics
NPI:1891720595
Name:STEEN, CHRISTIAN COLBERT
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:COLBERT
Last Name:STEEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 743904
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3904
Mailing Address - Country:US
Mailing Address - Phone:803-296-7320
Mailing Address - Fax:803-296-7330
Practice Address - Street 1:3010 FARROW RD
Practice Address - Street 2:SUITE 300
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-7607
Practice Address - Country:US
Practice Address - Phone:803-434-1210
Practice Address - Fax:803-434-1212
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC24959207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC249591Medicaid
SCAA14232353Medicare PIN
SC249591Medicaid