Provider Demographics
NPI:1134178890
Name:PREVITE, STEVEN ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ROBERT
Last Name:PREVITE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:231 SUTTON ST
Mailing Address - Street 2:UNIT 1D
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-1620
Mailing Address - Country:US
Mailing Address - Phone:978-686-3877
Mailing Address - Fax:978-686-9586
Practice Address - Street 1:231 SUTTON ST
Practice Address - Street 2:UNIT 1D
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-1620
Practice Address - Country:US
Practice Address - Phone:978-686-3877
Practice Address - Fax:978-686-9586
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2009-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA37150208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9719911Medicaid
MA6163866Medicaid
MA6163866Medicaid
MAPRD02056Medicare ID - Type Unspecified
MA9719911Medicaid