Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 25104 | MN |
NPI | 1013981844 |
---|---|
Provider Name | Richard D Steinberg |
First Address | Bloomington, MN 55425-1672 |
Second Address | Minneapolis, MN 55454-1321 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E19765 | (02) |