Provider Demographics
NPI:1598375503
Name:LANDER, STEVEN
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:LANDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2195 POPLAR AVE APT 504
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-2845
Mailing Address - Country:US
Mailing Address - Phone:918-408-9311
Mailing Address - Fax:
Practice Address - Street 1:920 MADISON AVE SUITE 531
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38163-2713
Practice Address - Country:US
Practice Address - Phone:918-408-9311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-04
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN66828207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine