Healthcare Provider Details

I. General information

NPI: 1295780252
Provider Name (Legal Business Name): STEPHEN ALAN GOLDSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 INVERNESS DR E SUITE 200
ENGLEWOOD CO
80112-5137
US

IV. Provider business mailing address

125 INVERNESS DR E SUITE 200
ENGLEWOOD CO
80112-5137
US

V. Phone/Fax

Practice location:
  • Phone: 303-708-8234
  • Fax: 303-649-9694
Mailing address:
  • Phone: 303-708-8234
  • Fax: 303-649-9694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number26645
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: