Provider Demographics
NPI:1154554970
Name:MICHAEL E. STEUER, MD, PC
Entity type:Organization
Organization Name:MICHAEL E. STEUER, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:JOY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GROOMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-349-9990
Mailing Address - Street 1:122 AIRWAYS PL
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-5872
Mailing Address - Country:US
Mailing Address - Phone:662-349-9990
Mailing Address - Fax:662-349-2620
Practice Address - Street 1:1150 US HIGHWAY 51 BYP W
Practice Address - Street 2:SUITE B
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-1888
Practice Address - Country:US
Practice Address - Phone:731-288-0428
Practice Address - Fax:731-288-0427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-27
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35059174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN38775190Medicare PIN