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General NPI Number Information
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NPI Number | 1174200158
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Entity Type | Organization
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Legal Business Name | PEDIATRICS OF STEAMBOAT SPRINGS
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Dates
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Enumeration Date | 06/30/2023
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 426 OAK ST
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City | STEAMBOAT SPRINGS
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State | CO
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Zip | 80487
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Country | US
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Telephone | 970-975-6250
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Fax |
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Provider Business Mailing Address
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Address Line | 940 CENTRAL PARK DR STE 201
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City | STEAMBOAT SPRINGS
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State | CO
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Zip | 80487-8853
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Country | US
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Telephone | 970-875-6250
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | SHEILA MARIE FOUNTAIN
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Credential | MD
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Telephone | 970-875-6250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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