Provider Demographics
NPI:1457393779
Name:AGLER, STEVEN D (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:D
Last Name:AGLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68047 W TERRITORIAL RD
Mailing Address - Street 2:
Mailing Address - City:BENTON HARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49022-9028
Mailing Address - Country:US
Mailing Address - Phone:269-463-7655
Mailing Address - Fax:269-463-3698
Practice Address - Street 1:6418 DEANS HILL RD
Practice Address - Street 2:
Practice Address - City:BERRIEN CENTER
Practice Address - State:MI
Practice Address - Zip Code:49102-8713
Practice Address - Country:US
Practice Address - Phone:269-815-5500
Practice Address - Fax:269-815-5373
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIT32673Medicare UPIN
MI0P07410Medicare ID - Type Unspecified