1881881118 NPI number — STEVEN E OZERAN, M.D., P.A.

Table of content: MR. DANIEL JOSEPH TURCICH LMSW (NPI 1063706117)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881881118 NPI number — STEVEN E OZERAN, M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STEVEN E OZERAN, M.D., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881881118
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/01/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1630 23RD AVE
Provider Second Line Business Mailing Address:
SUITE 901A
Provider Business Mailing Address City Name:
LEWISTON
Provider Business Mailing Address State Name:
ID
Provider Business Mailing Address Postal Code:
83501-6350
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
208-746-4479
Provider Business Mailing Address Fax Number:
208-746-4186

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1630 23RD AVE
Provider Second Line Business Practice Location Address:
SUITE 901A
Provider Business Practice Location Address City Name:
LEWISTON
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83501-6350
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-746-4479
Provider Business Practice Location Address Fax Number:
208-746-4186
Provider Enumeration Date:
10/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
JEFFREYS
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
ANNETTE
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
208-746-4479

Provider Taxonomy Codes

  • Taxonomy code: 2086S0122X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10143154 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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