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General NPI Number Information
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NPI Number | 1386738136
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Entity Type | Individual
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Provider Name | SCOTT MICHAEL SULENTICH 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 | 10/16/2025
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Provider Practice Location Address
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Address Line | 940 CENTRAL PARK DR #106
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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 | 970-879-4444
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Fax | 970-871-0662
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Provider Business Mailing Address
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Address Line | 1180 COLLEGE DR STE 3-3
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City | ROCK SPRINGS
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State | WY
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Zip | 82901-5863
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Country | US
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Telephone | 307-362-8211
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Fax | 307-382-3451
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 32976
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License Number State | CO
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