Provider Demographics
NPI:1750344099
Name:STEADMAN, MARK CHRISTOPHER (OD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:CHRISTOPHER
Last Name:STEADMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:262 MAIN DUNSTABLE RD
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-1941
Mailing Address - Country:US
Mailing Address - Phone:603-598-1620
Mailing Address - Fax:603-598-1624
Practice Address - Street 1:221 DANIEL WEBSTER HWY
Practice Address - Street 2:DANIEL WEBSTER PLAZA
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-5503
Practice Address - Country:US
Practice Address - Phone:603-888-1620
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-08
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH519152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHSTRE0888Medicare UPIN