Provider Demographics
NPI:1578590030
Name:WALTMAN, STEVEN EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:EDWARD
Last Name:WALTMAN
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 1:10870 W CHARLESTON BLVD.
Mailing Address - Street 2:#170B
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135
Mailing Address - Country:US
Mailing Address - Phone:702-273-3680
Mailing Address - Fax:702-800-3112
Practice Address - Street 1:10870 W CHARLESTON BLVD.
Practice Address - Street 2:#170B
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135
Practice Address - Country:US
Practice Address - Phone:702-273-3680
Practice Address - Fax:702-800-3112
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12256174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
S7175Medicare PIN