Distefano, Michael

Distefano, Michael is an individual health care provider with primary practice located at 13123 E 16Th Ave , Aurora CO 80045-7106. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is his primary health care specialty. Distefano, Michael can be contacted via phone (720) 777-1234.

Contact Information

Primary practice address
13123 E 16Th Ave Aurora CO 80045-7106
Phone: (720) 777-1234
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X M2307 Texas
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X 51012 Colorado

Profile Details

NPI number 1669552006
LBN Legal business name Distefano, Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2006
Last updated Jul 3rd, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669552006 NPPES
Texas MEDICAID 177033101

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