Provider Demographics
NPI:1881789139
Name:BORMANN, STEVEN WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:WILLIAM
Last Name:BORMANN
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 1:4000 CAMBRIDGE ST STE G600
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8501
Mailing Address - Country:US
Mailing Address - Phone:913-588-9600
Mailing Address - Fax:
Practice Address - Street 1:4000 CAMBRIDGE ST STE G600
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8500
Practice Address - Country:US
Practice Address - Phone:913-588-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006031507207RC0000X
KS04-32078207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO41329011OtherBC BS KC
KS200572000BMedicaid
KS200572000AMedicaid
KS110330002Medicare PIN
MO038A00004Medicare PIN
MO41329011OtherBC BS KC
KS200572000BMedicaid
KSP006701619Medicare PIN
KSP006701619Medicare PIN