Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. STEFAN RANDOLPH MAXWELL M.D.
NPI 1164473534
Pediatrics - Neonatal-Perinatal Medicine in Charleston, WV

Q: What is Stefan Maxwell's NPI number?

The NPI number for Stefan Maxwell is 1164473534. It was assigned to this individual provider in the NPPES registry on May 12, 2006.

Q: What is Stefan Maxwell's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.

Q: When was this NPI record last updated?

The NPPES record for Stefan Maxwell was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 38 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 12, 2006PECOS Enrolled

830 PENNSYLVANIA AVE, SUITE 406, CHARLESTON, WV 25302(304) 388-2238(304) 388-2243 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Dr. Stefan Randolph Maxwell M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. STEFAN RANDOLPH MAXWELL M.D. (NPI 1164473534) is an individual neonatal-perinatal medicine provider in Charleston, West Virginia, licensed in West Virginia (16172) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164473534

Entity TypeIndividualMale

Primary Taxonomy2080N0001X

Provider Legal NameDR. STEFAN RANDOLPH MAXWELLCredential: M.D.

Location Address830 PENNSYLVANIA AVE, SUITE 406Charleston, WV 25302-3302

Mailing Address5 Chatham RdCharleston, WV 25304-2763 · (304) 926-6428 · Fax (304) 926-8607

Phone(304) 388-2238

Fax(304) 388-2243

Sole ProprietorNo

Enumeration DateMay 12, 2006

Last NPPES UpdateJuly 13, 2026

✔ NPI 1164473534 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Neonatal-Perinatal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080N0001X

License✔ Licensed in WV · 16172

Definition

A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.

830 PENNSYLVANIA AVE, Charleston, WV 25302

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Stefan Randolph Maxwell M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. STEPHEN HAROLD BUSH MD

Obstetrics & Gynecology

830 PENNSYLVANIA AVE
CHARLESTON, WV 25302

Kanawha County (304) 388-1515

DR. JOHN M ECKERD M.D.

Pediatrics (Pediatric Cardiology)

830 PENNSYLVANIA AVE, SUITE 103
CHARLESTON, WV 25302

Kanawha County (304) 388-1552

CARRIE MARIE BUSH M.D.

Otolaryngology

830 PENNSYLVANIA AVE, SUITE 405
CHARLESTON, WV 25302

Kanawha County (304) 388-2980

MARCUS DODDRIDGE SHAFFER M.D.

Otolaryngology

830 PENNSYLVANIA AVE, SUITE 302
CHARLESTON, WV 25302

Kanawha County (304) 388-2950

PICKENS A. GANTT II M.D.

Obstetrics & Gynecology (Reproductive Endocrinology)

830 PENNSYLVANIA AVE, SUITE 205
CHARLESTON, WV 25302

Kanawha County (304) 388-2863

MS. JENNIFER DIVITA D.O.

Pediatrics

830 PENNSYLVANIA AVE, STE 200
CHARLESTON, WV 25302

Kanawha County (304) 388-2709

INTEGRATED HEALTH CARE PROVIDERS, INC.

Clinical Medical Laboratory

830 PENNSYLVANIA AVE, SUITE 302
CHARLESTON, WV 25302

Kanawha County (304) 388-2950

SCOTT A. NAEGELE, MD, PLLC

Obstetrics & Gynecology

830 PENNSYLVANIA AVE, SUITE 108
CHARLESTON, WV 25302

Kanawha County (304) 344-8368

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stefan Maxwell's NPI number?

The NPI number for Stefan Maxwell is 1164473534. It was assigned to this individual provider in the NPPES registry on May 12, 2006.

Where is Stefan Maxwell located?

Stefan Maxwell practices at 830 Pennsylvania Ave Suite 406, Charleston, WV 25302. The listed phone number is (304) 388-2238.

What is Stefan Maxwell's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.

Is Stefan Maxwell enrolled in Medicare?

Yes. Stefan Maxwell is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Stefan Maxwell was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 38 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.