Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 12009982A | IN |
NPI | 1104920453 |
---|---|
Provider Name | Christian Matthew Steffey |
First Address | Lafayette, IN 47904-2694 |
Second Address | Lafayette, IN 47904-2694 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2006 |
Last Update Date | 08/07/2007 |