Provider Demographics
NPI:1306926597
Name:TREBIL, STEVEN MICHAEL (BC-HIS)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:MICHAEL
Last Name:TREBIL
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35548 CTY RD 66
Mailing Address - Street 2:
Mailing Address - City:CROSSLAKE
Mailing Address - State:MN
Mailing Address - Zip Code:56442
Mailing Address - Country:US
Mailing Address - Phone:218-692-6072
Mailing Address - Fax:218-692-6073
Practice Address - Street 1:17274 STATE HIGHWAY 371
Practice Address - Street 2:
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-6818
Practice Address - Country:US
Practice Address - Phone:218-825-7349
Practice Address - Fax:218-828-1037
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2077174400000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN41-1588057OtherFEDERAL IDENTIFICATION
MN2077OtherSTATE LICENSE
MN3985959001OtherMINNESOTA STATE IDENTIFIC