Provider Demographics
NPI:1508804303
Name:KAGAN, STEVEN ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ANTHONY
Last Name:KAGAN
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 1:7700 OAKMONT PL
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-5492
Mailing Address - Country:US
Mailing Address - Phone:919-790-1472
Mailing Address - Fax:
Practice Address - Street 1:7700 OAKMONT PL
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5492
Practice Address - Country:US
Practice Address - Phone:919-790-1472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2024-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC846792086S0129X
NC2003000512086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00016338OtherMEDICARE RAILROAD
NC133T0OtherBLUE CROSS BLUE SHIELD
NC2007013OtherUNITED HEALTHCARE
NC89133T0Medicaid
NCC6899OtherMEDCOST
NC5769414OtherAETNA
NC803526OtherPARTNERS MEDICARE
NC2007013OtherUNITED HEALTHCARE
NCP00016338OtherMEDICARE RAILROAD