Provider Demographics
NPI:1750352282
Name:WAXMAN, STEVE W (MD)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:W
Last Name:WAXMAN
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 1:823 SW MULVANE ST.
Mailing Address - Street 2:STE. 275
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1764
Mailing Address - Country:US
Mailing Address - Phone:785-270-4355
Mailing Address - Fax:785-270-4364
Practice Address - Street 1:823 SW MULVANE ST STE 275
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1687
Practice Address - Country:US
Practice Address - Phone:785-270-4355
Practice Address - Fax:785-270-4364
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1009018482208800000X, 208800000X
KS04-22090208800000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FW1497482OtherDEA
IAP00615932Medicare PIN
IAI0923069Medicare PIN