MEDICARE: STEPHEN MARSHALL CORRIZ DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	A125764	NM
2	207R00000X	Internal Medicine Physician	A125764	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346343324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN MARSHALL CORRIZ DO

Provider Business Mailing Address
First Line	:	3450 ZAFARANO DRIVE SUITE C
Second Line	:	ASPEN MEDICAL GROUP, LLC
City	:	SANTA FE
State	:	NM
Zip	:	87507
Country	:	US
Telephone Number	:	505-466-5885
Fax Number	:	505-466-5886

Provider Business Practice Location Address
First Line	:	3450 ZAFARANO DRIVE SUITE C
Second Line	:	ASPEN MEDICAL GROUP, LLC
City	:	SANTA FE
State	:	NM
Zip	:	87507-2669
Country	:	US
Telephone Number	:	505-466-5885
Fax Number	:	505-466-5886

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	10/14/2013

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