Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 04-41055 | KS |
N | 207V00000X | Obstetrician & Gynecologist | 2018002920 | MO |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 04-41055 | KS |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 2018002920 | MO |
NPI | 1205836251 |
---|---|
Provider Name | Stephen J Wassinger |
First Address | Kansas City, MO 64131-4517 |
Second Address | Kansas City, MO 64111 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 26/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G47814 | (02) |