Individual
S STEVEN MAXOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 W POPLAR ST, WALLA WALLA, WA 99362-2846
(509) 522-5731
(509) 522-5747
Mailing address
PO BOX 32, LIBERTY LAKE, WA 99019-0032
(509) 522-5731
(509) 522-5747
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD00039933
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0149754
LABOR AND INDUSTRY
WA
01
—
110228191
RAILROAD MEDICARE
WA
05
—
8277857
—
WA
01
—
MD00039933
STATE LICENSE NUMBER
WA
Enumeration date
05/26/2006
Last updated
06/17/2021
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