Provider Demographics
NPI:1528103777
Name:STEUDEL, WOLFGANG THEODORE (MD)
Entity type:Individual
Prefix:DR
First Name:WOLFGANG
Middle Name:THEODORE
Last Name:STEUDEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6011 SWAYNE DR NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98516-9145
Mailing Address - Country:US
Mailing Address - Phone:253-968-0094
Mailing Address - Fax:253-968-0094
Practice Address - Street 1:MADIGAN ARMY MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-1100
Practice Address - Country:US
Practice Address - Phone:253-968-0094
Practice Address - Fax:253-968-0100
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00010714207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease