1326109588 NPI number — STEVEN A WEINMAN MD, PHD

Table of content: STEVEN A WEINMAN MD, PHD (NPI 1326109588)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326109588 NPI number — STEVEN A WEINMAN MD, PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEINMAN
Provider First Name:
STEVEN
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD, PHD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326109588
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/28/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3901 RAINBOW BLVD, RM 4035
Provider Second Line Business Mailing Address:
WESCOE MAILSTOP 1023
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66160
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-588-6003
Provider Business Mailing Address Fax Number:
913-588-3975

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3901 RAINBOW BLVD, RM 4035
Provider Second Line Business Practice Location Address:
WESCOE MAILSTOP 1023
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
409-772-2222
Provider Business Practice Location Address Fax Number:
409-772-0885
Provider Enumeration Date:
12/12/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , with the licence number:  H7251 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 04-33702 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 116735502 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".