Healthcare Provider Details

I. General information

NPI: 1609342922
Provider Name (Legal Business Name): BEAR VALLEY MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2018
Last Update Date: 07/10/2020
Certification Date: 07/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

442 OAK STREET
STEAMBOAT SPRINGS CO
80487-0000
US

IV. Provider business mailing address

PO BOX 881840
STEAMBOAT SPRINGS CO
80488-1840
US

V. Phone/Fax

Practice location:
  • Phone: 970-875-6062
  • Fax: 970-875-5741
Mailing address:
  • Phone: 970-846-4665
  • Fax: 970-875-5741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CATHERINE CANTWAY
Title or Position: MEMBER
Credential: MD
Phone: 970-846-4665