Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 30-018163 | OH |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 30-018163 | OH |
N | 204E00000X | Oral & Maxillofacial Surgeon | 30018163 | OH |
NPI | 1255393237 |
---|---|
Provider Name | Frederick Steinbeck |
First Address | Fort Thomas, KY 41075-1727 |
Second Address | Fort Thomas, KY 41075-1727 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2006 |
Last Update Date | 27/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64062227 | OWEL (01) | |
E95333 | (02) | OH |
ST0615642 | OHME (01) |