1861531964 NPI number — DR. STEVEN M CULP

Table of content: DR. STEVEN M CULP (NPI 1861531964)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861531964 NPI number — DR. STEVEN M CULP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CULP
Provider First Name:
STEVEN
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CULP
Provider Other First Name:
STEVEN
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1861531964
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1854 MINNESOTA AVE
Provider Second Line Business Mailing Address:
ST. 3
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66102-4122
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-371-1474
Provider Business Mailing Address Fax Number:
913-371-1474

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1854 MINNESOTA AVE
Provider Second Line Business Practice Location Address:
ST. 3
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66102-4122
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-371-1474
Provider Business Practice Location Address Fax Number:
913-371-1474
Provider Enumeration Date:
02/05/2007

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: 1223G0001X , with the licence number:  6121 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 11040010 . This is a "BLUE CROSS BLUESHIELD" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 27993 . This is a "BLUE CROSS BLUE SHIELD OF" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




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