Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | PO1438 | FL |
NPI | 1316912322 |
---|---|
Provider Name | Steven K Greenhut |
First Address | Callahan, FL 32011 |
Second Address | Callahan, FL 32011-8110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 02/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0412431-01 | (05) | FL |
U18387 | (02) | FL |