Provider Demographics
NPI:1184605958
Name:STEINBUCHEL, PETRA HEIKE (MD)
Entity type:Individual
Prefix:DR
First Name:PETRA
Middle Name:HEIKE
Last Name:STEINBUCHEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 OLD LANTERN LN # B
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:MA
Mailing Address - Zip Code:01450-2201
Mailing Address - Country:US
Mailing Address - Phone:617-233-3048
Mailing Address - Fax:617-726-5567
Practice Address - Street 1:15 OLD LANTERN LN # B
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:MA
Practice Address - Zip Code:01450-2201
Practice Address - Country:US
Practice Address - Phone:617-233-3048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2240312084P0800X
CAA824522084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry