Healthcare Provider Details

I. General information

NPI: 1760574008
Provider Name (Legal Business Name): SHABNUM ESTHER MATTHEWS-VU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 10/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4190 E WOODMEN ROAD, #100
COLORADO SPRINGS CO
80920
US

IV. Provider business mailing address

4190 E WOODMEN ROAD, #100
COLORADO SPRINGS CO
80920
US

V. Phone/Fax

Practice location:
  • Phone: 719-632-4455
  • Fax: 719-633-4613
Mailing address:
  • Phone: 719-632-4455
  • Fax: 719-633-4613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number42314
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: