Provider Demographics
NPI:1447284880
Name:UNTERMAN, STEVEN R (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:R
Last Name:UNTERMAN
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 1:3830 W 75TH ST
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-4128
Mailing Address - Country:US
Mailing Address - Phone:913-384-1441
Mailing Address - Fax:913-384-3437
Practice Address - Street 1:3830 W 75TH ST
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-4128
Practice Address - Country:US
Practice Address - Phone:913-384-1441
Practice Address - Fax:913-384-3437
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS20599207W00000X
MOR3K23207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100113270BMedicaid
MO203043708Medicaid
MO203043708Medicaid
KSB89609Medicare UPIN