Provider Demographics
NPI:1053403253
Name:BROXTERMAN, STEVEN JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JOSEPH
Last Name:BROXTERMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9119 WEST 74TH STREET
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2229
Mailing Address - Country:US
Mailing Address - Phone:913-789-1980
Mailing Address - Fax:913-789-1990
Practice Address - Street 1:9119 WEST 74TH STREET
Practice Address - Street 2:SUITE 150
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66204-2229
Practice Address - Country:US
Practice Address - Phone:913-789-1980
Practice Address - Fax:913-789-1990
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2011-08-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS04-17192207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS355580OtherFIRSTGUARD
KS07085038OtherBLUE CROSS
E22777Medicare UPIN
KSE22777Medicare UPIN
KSS143829Medicare PIN