Provider Demographics
NPI:1851393953
Name:STEINBERGER, SIDNEY J (MD)
Entity type:Individual
Prefix:
First Name:SIDNEY
Middle Name:J
Last Name:STEINBERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2708 CRAWFIS BLVD
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-2850
Mailing Address - Country:US
Mailing Address - Phone:330-869-6673
Mailing Address - Fax:330-864-3270
Practice Address - Street 1:2708 CRAWFIS BLVD
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-2850
Practice Address - Country:US
Practice Address - Phone:330-869-6673
Practice Address - Fax:330-864-3270
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-02
Last Update Date:2010-11-08
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
OH35052873207Y00000X, 207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0606231Medicaid
OH0606231Medicaid
OHA16271Medicare UPIN