Provider Demographics
NPI:1427158062
Name:WERDER, STEVEN F (DO)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:F
Last Name:WERDER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:3011 N MICHIGAN ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-2546
Mailing Address - Country:US
Mailing Address - Phone:620-231-9873
Mailing Address - Fax:620-231-2808
Practice Address - Street 1:2990 MILITARY AVE
Practice Address - Street 2:
Practice Address - City:BAXTER SPRINGS
Practice Address - State:KS
Practice Address - Zip Code:66713-2331
Practice Address - Country:US
Practice Address - Phone:620-856-2900
Practice Address - Fax:620-856-2901
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS05-230612084P0800X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100332790CMedicaid
KS100332790CMedicaid
KS103410Medicare ID - Type Unspecified