Basic Information
| Provider Information | |||||||||
| NPI: | 1851497184 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GREER | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | ORLAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5579 | ||||||||
| Address2: | |||||||||
| City: | BEND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 977085579 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5415491318 | ||||||||
| FaxNumber: | 5415886002 | ||||||||
| Practice Location | |||||||||
| Address1: | 630 N ARROWLEAF TRL | ||||||||
| Address2: | |||||||||
| City: | SISTERS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 977592610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5415491318 | ||||||||
| FaxNumber: | 5415886002 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2006 | ||||||||
| LastUpdateDate: | 10/31/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 6209 | AK | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | MD16297 | OR | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 000435 | 05 | OR | MEDICAID |