Provider Demographics
NPI:1750379053
Name:WESTGATE, STEVEN J (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:WESTGATE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1705 E BROADWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-5852
Mailing Address - Country:US
Mailing Address - Phone:573-874-7800
Mailing Address - Fax:573-443-3627
Practice Address - Street 1:115 BUSINESS LOOP 70 W
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-3244
Practice Address - Country:US
Practice Address - Phone:573-882-8644
Practice Address - Fax:573-882-8817
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR5G992085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
112025OtherBCBS OF MO
1600402OtherUNITED HEALTH CARE
33291OtherGHP
A13545OtherMERCY HEALTH PLANS
126628OtherHEALTHLINK
MO202798500Medicaid
MO202798542Medicaid
65201A013OtherTRICARE
23326029OtherBCBS OF KC
5132415OtherAETNA
KSH387761Medicare PIN
23326029OtherBCBS OF KC
1600402OtherUNITED HEALTH CARE
MO127530004Medicare PIN
MO300036602Medicare PIN
MO920003526Medicare PIN
112025OtherBCBS OF MO
MOMA1231008Medicare PIN
65201A013OtherTRICARE
MO202798500Medicaid