Basic Information
Provider Information
NPI: 1215905799
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WINKEL
FirstName: STEVEN
MiddleName: PAUL
NamePrefix: DR.
NameSuffix:  
Credential: DO, FACP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 700 ATTUCKS LN
Address2: SUITE 1-E
City: HYANNIS
State: MA
PostalCode: 026011809
CountryCode: US
TelephoneNumber: 5087715770
FaxNumber: 5087715774
Practice Location
Address1: 700 ATTUCKS LN
Address2: SUITE 1-E
City: HYANNIS
State: MA
PostalCode: 026011809
CountryCode: US
TelephoneNumber: 5087715770
FaxNumber: 5087715774
Other Information
ProviderEnumerationDate: 03/09/2006
LastUpdateDate: 04/15/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2083X0100X210013MAY Allopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine

ID Information
IDTypeStateIssuerDescription
220220801MAUNITEDOTHER
804512501MACIGNAOTHER
AA1081501MAHPHCOTHER
21001301MATUFTSOTHER
J2509001MABCBSOTHER
019597905MA MEDICAID


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