Provider Demographics
NPI:1730911900
Name:STEELEMD
Entity type:Organization
Organization Name:STEELEMD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:AJ
Authorized Official - Middle Name:
Authorized Official - Last Name:YERGENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:435-986-9369
Mailing Address - Street 1:148 S 1100 E
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2817
Mailing Address - Country:US
Mailing Address - Phone:385-336-7461
Mailing Address - Fax:
Practice Address - Street 1:310 N 850 E STE A
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-8623
Practice Address - Country:US
Practice Address - Phone:385-336-7461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-16
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty