Provider Demographics
NPI:1821199480
Name:WEAVER, STEVEN C (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:C
Last Name:WEAVER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1209 NW NORTH RIDGE DR STE B
Mailing Address - Street 2:ANESTHESIA SERVICES OF BLUE SPRINGS
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-6320
Mailing Address - Country:US
Mailing Address - Phone:816-988-8415
Mailing Address - Fax:816-988-8395
Practice Address - Street 1:1209 NW NORTH RIDGE DR STE B
Practice Address - Street 2:ANESTHESIA SERVICES OF BLUE SPRINGS
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-6320
Practice Address - Country:US
Practice Address - Phone:816-988-8415
Practice Address - Fax:816-988-8395
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR4A24207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202951521Medicaid
MOP00297152Medicare PIN
MO202951521Medicaid
MOS555160Medicare PIN
MOP00437230Medicare PIN
MOP00437230Medicare PIN