Provider Demographics
NPI:1700992054
Name:KATZMAN, STEVEN (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:KATZMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22021 ECORSE RD
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-1847
Mailing Address - Country:US
Mailing Address - Phone:313-291-4444
Mailing Address - Fax:313-291-7540
Practice Address - Street 1:29911 6 MILE RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3603
Practice Address - Country:US
Practice Address - Phone:734-513-1600
Practice Address - Fax:734-513-1623
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101010946207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4430690Medicaid
MI0Q26421Medicare ID - Type Unspecified
MI4430690Medicaid