Provider Demographics
NPI:1770784357
Name:STEELE, SPENCER JOHN (MD)
Entity type:Individual
Prefix:
First Name:SPENCER
Middle Name:JOHN
Last Name:STEELE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1376
Mailing Address - Street 2:
Mailing Address - City:GARDNERVILLE
Mailing Address - State:NV
Mailing Address - Zip Code:89410
Mailing Address - Country:US
Mailing Address - Phone:775-266-4151
Mailing Address - Fax:
Practice Address - Street 1:480 GALLETI WAY
Practice Address - Street 2:NORTHERN NEVADA ADULT MENTAL HEALTH SERVICES
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89431
Practice Address - Country:US
Practice Address - Phone:775-688-2011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRL002332084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F18231Medicare UPIN