Provider Demographics
NPI:1295990471
Name:WERNER, STEVEN DOUGLAS JR (DO)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:DOUGLAS
Last Name:WERNER
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33423 N 32ND AVE STE 2200
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-8874
Mailing Address - Country:US
Mailing Address - Phone:623-683-8000
Mailing Address - Fax:480-882-5887
Practice Address - Street 1:33423 N 32ND AVE STE 2200
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-8874
Practice Address - Country:US
Practice Address - Phone:623-683-8000
Practice Address - Fax:480-882-5887
Is Sole Proprietor?:No
Enumeration Date:2008-07-27
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA246319207XS0114X
AZ005825207X00000X, 207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ687932Medicaid
MA246319OtherMA MEDICAL LICENSE
OH34.009446OtherOH MEDICAL LICENSE
AZ687932Medicaid
MI5101018045OtherMI MEDICAL LICENSE