Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | MA 028351 | NJ |
NPI | 1003944414 |
---|---|
Provider Name | Dr. William Michael Steck |
First Address | West Orange, NJ 07052 |
Second Address | West Orange, NJ 07052 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2007 |
Last Update Date | 01/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1321901 | (05) | NJ |
C61214 | (02) | NJ |