MEDICARE: STEPHEN J WASSINGER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	2018002920	MO
2	207V00000X	Obstetrics & Gynecology Physician	04-41055	KS
3	207VF0040X	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician	04-41055	KS
4	207VF0040X	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician	2018002920	MO

General Provider Information

NPI Number	:	1205836251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN J WASSINGER MD

Provider Business Mailing Address
First Line	:	901 E 104TH ST
Second Line	:	MAILSTOP 400
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-4517
Country	:	US
Telephone Number	:	816-599-9499
Fax Number	:	816-932-9670

Provider Business Practice Location Address
First Line	:	4321 WASHINGTON ST STE 5000
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111
Country	:	US
Telephone Number	:	816-932-1785
Fax Number	:	816-932-1382

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	09/26/2018

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