Healthcare Provider Details

I. General information

NPI: 1578091633
Provider Name (Legal Business Name): STEFAN GARCIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2017
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 AURORA CT FL 4
AURORA CO
80045-2541
US

IV. Provider business mailing address

1500 EAST MEDICAL CENTER DR. TC2319, SPC5328
ANN ARBOR MI
48109
US

V. Phone/Fax

Practice location:
  • Phone: 720-848-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number4301112883
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberDR.0068155
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License NumberDR.0068155
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: