Healthcare Provider Details

I. General information

NPI: 1184811838
Provider Name (Legal Business Name): SCOTT M. SULENTICH MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2007
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 CENTRAL PARK DR STE 106
STEAMBOAT SPRINGS CO
80487-8816
US

IV. Provider business mailing address

1180 COLLEGE DR STE 3-3
ROCK SPRINGS WY
82901-5863
US

V. Phone/Fax

Practice location:
  • Phone: 970-879-4444
  • Fax: 970-871-0662
Mailing address:
  • Phone: 307-362-8211
  • Fax: 307-382-3451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number32976
License Number StateCO

VIII. Authorized Official

Name: KATIE DOUGLAS
Title or Position: OFFICE MANAGER
Credential:
Phone: 970-879-4444