Provider Demographics
NPI:1467425066
Name:HARTLINE, STEVEN MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MICHAEL
Last Name:HARTLINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1933 EDWIN DR STE 208
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-6531
Mailing Address - Country:US
Mailing Address - Phone:757-252-5820
Mailing Address - Fax:757-963-9609
Practice Address - Street 1:1933 EDWIN DR STE 208
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-6531
Practice Address - Country:US
Practice Address - Phone:757-252-5820
Practice Address - Fax:757-963-9609
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101238589207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G84663Medicare UPIN