Healthcare Provider Details

I. General information

NPI: 1902835614
Provider Name (Legal Business Name): STEVEN C MATTHEWS PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 08/05/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5351 S ROSLYN ST STE 200
GREENWOOD VILLAGE CO
80111-2132
US

IV. Provider business mailing address

5351 S ROSLYN ST STE 200
GREENWOOD VILLAGE CO
80111-2132
US

V. Phone/Fax

Practice location:
  • Phone: 303-679-2070
  • Fax: 303-679-2071
Mailing address:
  • Phone: 303-679-2070
  • Fax: 303-679-2071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number1667
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA1667
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: