Provider Demographics
NPI:1356383434
Name:STEINWAND, GREGORY MARTIN (PSYD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:MARTIN
Last Name:STEINWAND
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 PINE ST
Mailing Address - Street 2:NO.11
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-3824
Mailing Address - Country:US
Mailing Address - Phone:303-444-4205
Mailing Address - Fax:720-565-3347
Practice Address - Street 1:2727 PINE ST
Practice Address - Street 2:NO.11
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-3824
Practice Address - Country:US
Practice Address - Phone:303-444-4205
Practice Address - Fax:720-565-3347
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO835103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC93456Medicare PIN