Provider Demographics
NPI:1548265218
Name:STEINBURG, RICK (PA-C)
Entity type:Individual
Prefix:
First Name:RICK
Middle Name:
Last Name:STEINBURG
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3085 E MAGIC VIEW DR # 140
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-3757
Mailing Address - Country:US
Mailing Address - Phone:208-433-9300
Mailing Address - Fax:208-433-9854
Practice Address - Street 1:3085 E MAGIC VIEW DR # 140
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-3757
Practice Address - Country:US
Practice Address - Phone:208-433-9300
Practice Address - Fax:208-433-9854
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPA357363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID806231600Medicaid
ID1667283Medicare ID - Type Unspecified
IDR03195Medicare UPIN