Healthcare Provider Details

I. General information

NPI: 1508827791
Provider Name (Legal Business Name): STEPHEN M SANTANGELO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 09/11/2020
Certification Date: 09/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 S YORK ST
DENVER CO
80210-1913
US

IV. Provider business mailing address

1260 S YORK ST
DENVER CO
80210-1913
US

V. Phone/Fax

Practice location:
  • Phone: 303-704-1801
  • Fax: 303-777-5619
Mailing address:
  • Phone: 720-810-8384
  • Fax: 303-777-5619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number44371
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: