Provider Demographics
NPI:1518290451
Name:KANTER, STEVEN KENNETH (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:KENNETH
Last Name:KANTER
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 1:4323 MORNING VIEW CT
Mailing Address - Street 2:K206
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-1236
Mailing Address - Country:US
Mailing Address - Phone:920-208-1822
Mailing Address - Fax:
Practice Address - Street 1:4323 MORNING VIEW CT
Practice Address - Street 2:K206
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-1236
Practice Address - Country:US
Practice Address - Phone:920-208-1822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-10
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG467352085R0202X
IL036.0711832085R0202X
WI32850-0202085R0202X
FLME 603282085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F24654Medicare UPIN