Haverly, Stephen Samuel
Haverly, Stephen Samuel is an individual health care provider with primary practice located at 1010 Three Springs Blvd , Durango CO 81301-8296. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Haverly, Stephen Samuel can be contacted via phone (303) 306-7783.Contact Information
Primary practice address
1010 Three Springs Blvd
Durango CO 81301-8296
Phone: (303) 306-7783
Fax: (303) 306-7753
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 42845 | Colorado |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | A77557 | California |
Profile Details
| NPI number | 1114034550 |
|---|---|
| LBN Legal business name | Haverly, Stephen Samuel |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 23rd, 2006 |
| Last updated | Apr 3rd, 2014 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114034550 | NPPES |
| Colorado | MEDICAID | 33457271 | |
| Colorado | Other | P00678278 | |
| Colorado | MEDICAID | 77988230 | |
| Colorado | MEDICAID | 00A775570 |
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