Provider Demographics
NPI:1669409181
Name:WILLEN, STEVE M (DC)
Entity type:Individual
Prefix:DR
First Name:STEVE
Middle Name:M
Last Name:WILLEN
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 1:3808 HIGH POINT RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-4713
Mailing Address - Country:US
Mailing Address - Phone:336-855-8560
Mailing Address - Fax:336-855-5938
Practice Address - Street 1:3808 HIGH POINT RD
Practice Address - Street 2:SUITE H
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-4713
Practice Address - Country:US
Practice Address - Phone:336-855-8560
Practice Address - Fax:336-855-5938
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC 1406111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC330532OtherACN
NC44-09021OtherUNITED HEALTH CARE
NC8444OtherPARTNERS
NC8908922Medicaid
NC08922OtherBCBS
NC24885OtherMEDCOST
NCT 64466Medicare UPIN
NC244431Medicare ID - Type Unspecified