Provider Demographics
NPI:1730992454
Name:STEELE, MATTHEW (RD, LD)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:STEELE
Suffix:
Gender:M
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 HARRISDALE ST
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37801-3893
Mailing Address - Country:US
Mailing Address - Phone:513-827-8335
Mailing Address - Fax:
Practice Address - Street 1:1027 HARRISDALE ST
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-3893
Practice Address - Country:US
Practice Address - Phone:513-827-8335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4504133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty