Provider Demographics
NPI:1427266899
Name:ZELTWANGER, SHAWN (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:
Last Name:ZELTWANGER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 N RIVERSIDE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64507-2507
Mailing Address - Country:US
Mailing Address - Phone:816-271-6518
Mailing Address - Fax:816-271-6539
Practice Address - Street 1:802 N RIVERSIDE RD STE 100
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64507-2507
Practice Address - Country:US
Practice Address - Phone:816-271-6518
Practice Address - Fax:816-271-6539
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004014124207L00000X
MO2008003498207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology