Basic Information
| Provider Information | |||||||||
| NPI: | 1740289602 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BILLS | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | W | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7910 GARDEN RD | ||||||||
| Address2: | |||||||||
| City: | HOLLAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435289661 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4198655654 | ||||||||
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| Practice Location | |||||||||
| Address1: | 838 E WOOSTER ST | ||||||||
| Address2: | |||||||||
| City: | BOWLING GREEN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 434023186 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193722271 | ||||||||
| FaxNumber: | 4193543222 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2005 | ||||||||
| LastUpdateDate: | 06/15/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 35069103 | OH | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2039430 | 05 | MI | MEDICAID | 000000550241 | 01 | OH | ANTHEM BLUE CROSS BLUE SHIELD | OTHER | 2039430 | 05 | OH | MEDICAID | 000000246974 | 01 | OH | ANTHEM | OTHER |