Provider Demographics
NPI:1700836046
Name:ANDREWS, WALTER STUART (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:STUART
Last Name:ANDREWS
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 1:2401 GILLHAM RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-4619
Mailing Address - Country:US
Mailing Address - Phone:813-234-3633
Mailing Address - Fax:816-983-6885
Practice Address - Street 1:2401 GILLHAM RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-4619
Practice Address - Country:US
Practice Address - Phone:813-234-3633
Practice Address - Fax:816-983-6885
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-279322086S0120X
MO1175902086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS04-27932OtherMEDICAL LICENSE
MO117590OtherMEDICAL LICENSE
MO203920905Medicaid
MO203920905Medicaid
MO203920905Medicaid