Shane, Stephan W

Shane, Stephan W is an individual health care provider with primary practice located at 859 S 4Th Ave , Brighton CO 80601-3543. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Shane, Stephan W can be contacted via phone (303) 338-4545.

Contact Information

Primary practice address
859 S 4Th Ave Brighton CO 80601-3543
Phone: (303) 338-4545
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036-098583 Illinois
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 47019 Colorado

Profile Details

NPI number 1447332424
LBN Legal business name Shane, Stephan W
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2006
Last updated Sep 9th, 2011 - about 14 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 1447332424 NPPES
Colorado MEDICAID 26588021
Colorado Other 019392
Colorado MEDICAID 036009853

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