Provider Demographics
NPI:1023651023
Name:SAVAGE, STEVEN MATTHEW
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:MATTHEW
Last Name:SAVAGE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 AMERICAN PACIFIC DR APT 1624
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7859
Mailing Address - Country:US
Mailing Address - Phone:661-609-6431
Mailing Address - Fax:
Practice Address - Street 1:1250 AMERICAN PACIFIC DR APT 1624
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7859
Practice Address - Country:US
Practice Address - Phone:661-609-6431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-22
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNA207PE0004X
NVPA0455363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services