Basic Information
Provider Information
NPI: 1710969290
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STEELE
FirstName: RICHARD
MiddleName: A
NamePrefix:  
NameSuffix: JR.
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 7232
Address2: DEPT 165
City: INDIANAPOLIS
State: IN
PostalCode: 462077232
CountryCode: US
TelephoneNumber: 3176149817
FaxNumber: 3176149655
Practice Location
Address1: 2001 W 86TH ST
Address2:  
City: INDIANAPOLIS
State: IN
PostalCode: 462601902
CountryCode: US
TelephoneNumber: 8662827905
FaxNumber: 8007310751
Other Information
ProviderEnumerationDate: 11/18/2005
LastUpdateDate: 03/04/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/04/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207LP2900X01027576INN Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
207L00000X01027576INY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
10036212005IN MEDICAID


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