MEDICARE: DR. ROBERT SHANE STEADMAN DC

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	111NN0400X	Neurology Chiropractor	5404	CO

General Provider Information

NPI Number	:	1760505333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT SHANE STEADMAN DC

Provider Business Mailing Address
First Line	:	3646 S GALAPAGO ST
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80110-3421
Country	:	US
Telephone Number	:	303-781-5617
Fax Number	:	303-781-1045

Provider Business Practice Location Address
First Line	:	3646 S GALAPAGO ST
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80110-3421
Country	:	US
Telephone Number	:	303-781-5617
Fax Number	:	303-781-1045

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

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	07/28/2008

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