Provider Demographics
NPI:1194717405
Name:STEELE, MICHAEL P (OD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:P
Last Name:STEELE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 HIGHLANDS BOULEVARD DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63011-4385
Mailing Address - Country:US
Mailing Address - Phone:636-686-7411
Mailing Address - Fax:
Practice Address - Street 1:301 HIGHLANDS BOULEVARD DR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63011-4385
Practice Address - Country:US
Practice Address - Phone:636-686-7411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004018280152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist