Provider Demographics
NPI:1316931785
Name:STEVEN R KUBEL DPM LTD
Entity type:Organization
Organization Name:STEVEN R KUBEL DPM LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ROGER
Authorized Official - Last Name:KUBEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:775-887-0400
Mailing Address - Street 1:212 SOUTH NEVADA STREET
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-4287
Mailing Address - Country:US
Mailing Address - Phone:775-887-0400
Mailing Address - Fax:775-887-0660
Practice Address - Street 1:212 SOUTH NEVADA STREET
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-4287
Practice Address - Country:US
Practice Address - Phone:775-887-0400
Practice Address - Fax:775-887-0660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-31
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9302213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVT11248Medicare UPIN
NVV38636Medicare PIN
NV5018350001Medicare NSC