Provider Demographics
NPI:1962666974
Name:STEVEN S DONCHEY MDPA
Entity type:Organization
Organization Name:STEVEN S DONCHEY MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:DONCHEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-897-4475
Mailing Address - Street 1:1950 BLUEWATER BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-3887
Mailing Address - Country:US
Mailing Address - Phone:850-897-4475
Mailing Address - Fax:850-897-1652
Practice Address - Street 1:1950 BLUEWATER BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-3887
Practice Address - Country:US
Practice Address - Phone:850-699-0757
Practice Address - Fax:850-331-3136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-18
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0060265207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty