Provider Demographics
NPI:1184293037
Name:HALE, STEVEN DOUGLAS (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:DOUGLAS
Last Name:HALE
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 1:1575 CONCENTRIC BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-9312
Mailing Address - Country:US
Mailing Address - Phone:989-746-7947
Mailing Address - Fax:
Practice Address - Street 1:1575 CONCENTRIC BLVD STE 1
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-9312
Practice Address - Country:US
Practice Address - Phone:989-746-7947
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351047575207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine