Basic Information
| Provider Information | |||||||||
| NPI: | 1447230487 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STEINER | ||||||||
| FirstName: | MALCOLM | ||||||||
| MiddleName: | LORI | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 N BREIEL BLVD | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450423808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5134242535 | ||||||||
| FaxNumber: | 5134240363 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 N BREIEL BLVD | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450423808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5134242535 | ||||||||
| FaxNumber: | 5134240363 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2006 | ||||||||
| LastUpdateDate: | 11/18/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 048433 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0607084 | 05 | OH | MEDICAID | 0636002 | 05 | OH | MEDICAID |