1144218132 NPI number — KRISTINA STEINBERG MD

Table of content: KRISTINA STEINBERG MD (NPI 1144218132)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144218132 NPI number — KRISTINA STEINBERG MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEINBERG
Provider First Name:
KRISTINA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1144218132
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/23/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1710 1ST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALAMOSA
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81101-2302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-589-3658
Provider Business Mailing Address Fax Number:
719-589-0997

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1710 1ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALAMOSA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81101-2302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-589-3658
Provider Business Practice Location Address Fax Number:
719-589-0997
Provider Enumeration Date:
10/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  25598 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 186095800 . This is a "US DEPARTMENT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01255983 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 080036223 . This is a "TRAVELERS MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 840706945017 . This is a "ROCKY MOUNTAIN HEALTH PLA" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: STH1018 . This is a "ANTHEM BCBS" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: X2884 . This is a "NEW MEXICO MEDICAID" identifier . This identifiers is of the category "OTHER".




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