Basic Information
Provider Information
NPI: 1275663056
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STEELE
FirstName: MARSHALL
MiddleName: K
NamePrefix: DR.
NameSuffix: III
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 108 FORBES ST
Address2:  
City: ANNAPOLIS
State: MD
PostalCode: 214011502
CountryCode: US
TelephoneNumber: 4102688862
FaxNumber: 4102804701
Practice Location
Address1: 108 FORBES ST
Address2:  
City: ANNAPOLIS
State: MD
PostalCode: 214011502
CountryCode: US
TelephoneNumber: 4102688862
FaxNumber: 4102804701
Other Information
ProviderEnumerationDate: 03/07/2007
LastUpdateDate: 05/05/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000XD20439MDY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207XX0005XD20439MDN Allopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine

No ID Information.


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