Healthcare Provider Details

I. General information

NPI: 1720341183
Provider Name (Legal Business Name): STEVEN L SNIVELY MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2012
Last Update Date: 09/25/2020
Certification Date: 09/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E HAMPDEN AVE STE 200
ENGLEWOOD CO
80113
US

IV. Provider business mailing address

601 E HAMPDEN AVE STE 200
ENGLEWOOD CO
80113-2788
US

V. Phone/Fax

Practice location:
  • Phone: 719-457-6200
  • Fax: 303-788-5363
Mailing address:
  • Phone: 719-457-6200
  • Fax: 303-788-5363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: STEVEN SNIVELY
Title or Position: OWNER
Credential: MD
Phone: 303-788-6445