Provider Demographics
NPI:1386601235
Name:LASTER, STEVEN B (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:B
Last Name:LASTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E 104TH ST
Mailing Address - Street 2:MAILSTOP 400S
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131
Mailing Address - Country:US
Mailing Address - Phone:816-502-7117
Mailing Address - Fax:816-932-9670
Practice Address - Street 1:4330 WORNALL RD
Practice Address - Street 2:SUITE 2000
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5939
Practice Address - Country:US
Practice Address - Phone:816-931-1883
Practice Address - Fax:816-756-3645
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR4J13207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100157230AMedicaid
KS100157230HMedicaid
KS100157230EOtherMEDICAID - CUSHING
MOP00836154OtherRAILROAD MEDICARE
KSP00842620OtherRAILROAD MEDICARE
KS100157230GMedicaid
MO202796819Medicaid
KSKA121039OtherMEDICARE - CUSHING
KSP00842620OtherRAILROAD MEDICARE
KSKA1724001Medicare PIN
KS100157230HMedicaid
MOP00836154OtherRAILROAD MEDICARE
KS100157230EOtherMEDICAID - CUSHING