Healthcare Provider Details

I. General information

NPI: 1801982400
Provider Name (Legal Business Name): STEPHEN H SHOGAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 E 9TH AVE STE 330
DENVER CO
80220-4042
US

IV. Provider business mailing address

4600 E 9TH AVE STE 330
DENVER CO
80220-4042
US

V. Phone/Fax

Practice location:
  • Phone: 303-563-2760
  • Fax: 303-322-0897
Mailing address:
  • Phone: 303-563-2760
  • Fax: 303-322-0897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number2016-01376
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number24544
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: