Provider Demographics
NPI:1316912322
Name:GREENHUT, STEVEN K (DPM)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:K
Last Name:GREENHUT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1578
Mailing Address - Street 2:
Mailing Address - City:CALLAHAN
Mailing Address - State:FL
Mailing Address - Zip Code:32011
Mailing Address - Country:US
Mailing Address - Phone:904-879-2552
Mailing Address - Fax:904-879-6360
Practice Address - Street 1:542067 US HWY 1
Practice Address - Street 2:
Practice Address - City:CALLAHAN
Practice Address - State:FL
Practice Address - Zip Code:32011-8110
Practice Address - Country:US
Practice Address - Phone:904-879-2552
Practice Address - Fax:904-879-6360
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO1438213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0412431-01Medicaid
FLU18387Medicare UPIN
FL87801Medicare ID - Type Unspecified