Healthcare Provider Details

I. General information

NPI: 1285686402
Provider Name (Legal Business Name): STEVEN AWNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 06/12/2021
Certification Date: 06/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 MAPLE RD
WILLIAMSVILLE NY
14221-3260
US

IV. Provider business mailing address

811 MAPLE RD
WILLIAMSVILLE NY
14221-3260
US

V. Phone/Fax

Practice location:
  • Phone: 716-631-8888
  • Fax: 716-631-3803
Mailing address:
  • Phone: 716-631-8888
  • Fax: 716-631-3803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0110X
TaxonomyPediatric Ophthalmology and Strabismus Specialist Physician Physician
License Number183761
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number183761
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: