Healthcare Provider Details

I. General information

NPI: 1811258007
Provider Name (Legal Business Name): KRISTEN M. SCAFF DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2012
Last Update Date: 10/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 E. 9TH AVE. STE #330
DENVER CO
80220
US

IV. Provider business mailing address

1707 COLE BLVD. STE #100
GOLDEN CO
80401
US

V. Phone/Fax

Practice location:
  • Phone: 303-388-4076
  • Fax: 303-320-0439
Mailing address:
  • Phone: 303-716-8018
  • Fax: 303-763-5495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number53950
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4252
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: