Provider Demographics
NPI:1336217462
Name:UROLOGY SPECIALISTS OF MARIETTA
Entity Type:Organization
Organization Name:UROLOGY SPECIALISTS OF MARIETTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:A
Authorized Official - Last Name:STEIGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-373-7828
Mailing Address - Street 1:400 MATTHEW ST
Mailing Address - Street 2:STE 303
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750
Mailing Address - Country:US
Mailing Address - Phone:740-373-7828
Mailing Address - Fax:740-373-5898
Practice Address - Street 1:400 MATTHEW ST
Practice Address - Street 2:STE 303
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750
Practice Address - Country:US
Practice Address - Phone:740-373-7828
Practice Address - Fax:740-373-5898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2124776Medicaid
G93941Medicare UPIN
ST087641Medicare ID - Type Unspecified