Provider Demographics
NPI:1992994776
Name:STEINMANN, CARL WILLIAM (PA)
Entity type:Individual
Prefix:MR
First Name:CARL
Middle Name:WILLIAM
Last Name:STEINMANN
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:3340 E GOLDSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-1026
Mailing Address - Country:US
Mailing Address - Phone:208-302-7100
Mailing Address - Fax:208-302-7155
Practice Address - Street 1:315 E ELM ST
Practice Address - Street 2:STE 100
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605
Practice Address - Country:US
Practice Address - Phone:208-302-7100
Practice Address - Fax:208-302-7155
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDPA-718363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID807922200Medicaid
ID807922200Medicaid