Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 017234 | ME |
NPI | 1003910126 |
---|---|
Provider Name | Scott M Steidl |
First Address | Portland, ME 04102-2625 |
Second Address | Portland, ME 04102-2625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2006 |
Last Update Date | 17/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
432349099 | (05) | ME |
F54585 | (02) | ME |