Provider Demographics
NPI:1396719035
Name:ROVENSTINE, STEVEN L (DO)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:L
Last Name:ROVENSTINE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 RAVEN HILL DRIVE
Mailing Address - Street 2:
Mailing Address - City:ATCHISON
Mailing Address - State:KS
Mailing Address - Zip Code:66002
Mailing Address - Country:US
Mailing Address - Phone:913-367-2131
Mailing Address - Fax:913-674-2023
Practice Address - Street 1:800 RAVEN HILL DRIVE
Practice Address - Street 2:
Practice Address - City:ATCHISON
Practice Address - State:KS
Practice Address - Zip Code:66002
Practice Address - Country:US
Practice Address - Phone:913-367-2131
Practice Address - Fax:913-674-2023
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005018834207Q00000X
KS0530786207Q00000X, 207P00000X
KS05-30786207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200261310BMedicaid
KSQ26D341Medicare ID - Type Unspecified
KS200261310BMedicaid
G80201Medicare UPIN