Provider Demographics
NPI:1336424571
Name:STEELE, BRIAN JAMES MATTHEW (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JAMES MATTHEW
Last Name:STEELE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 KALAMAZOO AVE SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49507-2115
Mailing Address - Country:US
Mailing Address - Phone:616-247-5521
Mailing Address - Fax:616-274-4604
Practice Address - Street 1:1601 KALAMAZOO AVE SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49507-2115
Practice Address - Country:US
Practice Address - Phone:616-247-5521
Practice Address - Fax:616-274-4604
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302032330183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist