Provider Demographics
NPI:1922082320
Name:STEELE, MARY E (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:E
Last Name:STEELE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ELIZABETH
Other - Last Name:RUPPERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8545 COMMON ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-2599
Mailing Address - Country:US
Mailing Address - Phone:586-751-0732
Mailing Address - Fax:586-751-3822
Practice Address - Street 1:8545 COMMON ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-2599
Practice Address - Country:US
Practice Address - Phone:586-751-0732
Practice Address - Fax:586-751-3822
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301059645207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OM29080002Medicare ID - Type Unspecified
G35827Medicare UPIN