Provider Demographics
NPI:1285601427
Name:ATWATER, STEVEN B (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:B
Last Name:ATWATER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:7301 OHMS LANE
Mailing Address - Street 2:STE 650
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439
Mailing Address - Country:US
Mailing Address - Phone:952-835-9880
Mailing Address - Fax:952-857-1554
Practice Address - Street 1:6500 EXCELSIOR BLVD
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426
Practice Address - Country:US
Practice Address - Phone:952-993-6080
Practice Address - Fax:952-993-6047
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-07
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MN27099207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
27099OtherMN MEDICAL LICENSE
27099OtherMN MEDICAL LICENSE