Provider Demographics
NPI:1922070218
Name:INGLE, STEVEN BRIAN (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:BRIAN
Last Name:INGLE
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 1:2841 DEBARR ROAD
Mailing Address - Street 2:SUITE 50
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2932
Mailing Address - Country:US
Mailing Address - Phone:907-276-2811
Mailing Address - Fax:907-276-2810
Practice Address - Street 1:2841 DEBARR ROAD
Practice Address - Street 2:SUITE 50
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2932
Practice Address - Country:US
Practice Address - Phone:907-276-2811
Practice Address - Fax:907-276-2810
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN47941207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN335437700Medicaid
AKMD0370Medicaid
WI35174200Medicaid
IAENROLLEDMedicaid
I34464Medicare UPIN
MN100000642Medicare PIN