Provider Demographics
NPI:1700883295
Name:STUEVER, KEVIN JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:JAMES
Last Name:STUEVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:325 MAINE ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-1360
Mailing Address - Country:US
Mailing Address - Phone:785-505-2988
Mailing Address - Fax:785-505-5228
Practice Address - Street 1:4525 W 6TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-2444
Practice Address - Country:US
Practice Address - Phone:785-843-5160
Practice Address - Fax:785-843-2524
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2023-10-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS0423816207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100133210AMedicaid
KS100133210AMedicaid
KSF27929Medicare UPIN