Provider Demographics
NPI:1972586634
Name:STEEN, SHARON (MD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:STEEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:KATHARINE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:105 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:BELLE PLAINE
Mailing Address - State:IA
Mailing Address - Zip Code:52208-2200
Mailing Address - Country:US
Mailing Address - Phone:319-444-3210
Mailing Address - Fax:319-444-4099
Practice Address - Street 1:105 9TH AVE
Practice Address - Street 2:
Practice Address - City:BELLE PLAINE
Practice Address - State:IA
Practice Address - Zip Code:52208-2200
Practice Address - Country:US
Practice Address - Phone:319-444-3210
Practice Address - Fax:319-444-4099
Is Sole Proprietor?:No
Enumeration Date:2005-11-26
Last Update Date:2007-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA35903207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA3486233Medicaid
IA5486233Medicaid
IA4486233Medicaid
IA2486233Medicaid
IA20087OtherWELLMARK BCBS
IA7486233Medicaid
IA1486233Medicaid
IA6486233Medicaid
IA2486233Medicaid
IA5486233Medicaid
IAI17760Medicare ID - Type Unspecified
IA1486233Medicaid