Provider Demographics
NPI:1548953045
Name:STEELE, RAVON EUGENE
Entity type:Individual
Prefix:
First Name:RAVON
Middle Name:EUGENE
Last Name:STEELE
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 1:19777 HOUGHTON ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-1860
Mailing Address - Country:US
Mailing Address - Phone:313-704-6838
Mailing Address - Fax:
Practice Address - Street 1:19777 HOUGHTON ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-1860
Practice Address - Country:US
Practice Address - Phone:313-704-6838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-31
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide