Provider Demographics
NPI:1770583445
Name:STEFFAN, MICHAEL FISHER SR (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:FISHER
Last Name:STEFFAN
Suffix:SR
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 517
Mailing Address - Street 2:320 PARK AVENUE
Mailing Address - City:BOCA GRANDE
Mailing Address - State:FL
Mailing Address - Zip Code:33921
Mailing Address - Country:US
Mailing Address - Phone:941-964-2276
Mailing Address - Fax:941-964-0158
Practice Address - Street 1:320 PARK AVE.
Practice Address - Street 2:
Practice Address - City:BOCA GRANDE
Practice Address - State:FL
Practice Address - Zip Code:33921
Practice Address - Country:US
Practice Address - Phone:941-964-2276
Practice Address - Fax:941-964-0158
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2011-06-16
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Provider Licenses
StateLicense IDTaxonomies
FLME 95958207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F03967Medicare UPIN