Healthcare Provider Details

I. General information

NPI: 1154434397
Provider Name (Legal Business Name): BARBARA D STATLAND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BARBARA S CLEARY MD

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BANNOCK ST MC 4000
DENVER CO
80204-4507
US

IV. Provider business mailing address

777 BANNOCK ST MC 4000
DENVER CO
80204-4507
US

V. Phone/Fax

Practice location:
  • Phone: 303-602-5011
  • Fax: 303-602-5056
Mailing address:
  • Phone: 303-602-5011
  • Fax: 303-602-5056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number39602
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: