Provider Demographics
NPI:1316055502
Name:STEELE, MAX M (MD)
Entity type:Individual
Prefix:DR
First Name:MAX
Middle Name:M
Last Name:STEELE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 9TH AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:SLC
Mailing Address - State:UT
Mailing Address - Zip Code:84103-3186
Mailing Address - Country:US
Mailing Address - Phone:801-408-2999
Mailing Address - Fax:801-408-5105
Practice Address - Street 1:370 9TH AVE
Practice Address - Street 2:STE 101
Practice Address - City:SLC
Practice Address - State:UT
Practice Address - Zip Code:84103-3186
Practice Address - Country:US
Practice Address - Phone:801-408-2999
Practice Address - Fax:801-408-5105
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT75-157638-1205207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT107005022101OtherSELECT HEALTH
UT5466OtherPEHP
UT201555OtherALTIUS
UT160047271OtherRR MEDICARE
UTD07804Medicare UPIN
UTU000000326Medicare PIN