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General NPI Number Information
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NPI Number | 1023102498
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Entity Type | Individual
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Provider Name | STEFAN J. CHIMOSKEY MD
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 06/12/2020
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Provider Practice Location Address
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Address Line | 3601 ARAPAHOE AVE UNIT D180
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City | BOULDER
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State | CO
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Zip | 80303-1584
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Country | US
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Telephone | 720-845-5858
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Fax | 505-288-3642
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Provider Business Mailing Address
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Address Line | PO BOX 26666 PHS PROVIDER ENROLLMENT
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City | ALBUQUERQUE
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State | NM
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Zip | 87125-6666
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Country | US
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Telephone | 505-923-5356
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Fax | 505-923-5354
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2001156
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207QS1201X
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Taxonomy Name | Sleep Medicine (Family Medicine) Physician
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License Number | 2001-156
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 207QS1201X
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Taxonomy Name | Sleep Medicine (Family Medicine) Physician
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License Number | 0052058
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License Number State | CO
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