Provider Demographics
NPI:1043644347
Name:SHIFFMAN, MICHELLE ROSE (MD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ROSE
Last Name:SHIFFMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1339 S FEDERAL BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-4235
Mailing Address - Country:US
Mailing Address - Phone:303-602-0002
Mailing Address - Fax:
Practice Address - Street 1:FEDERICO PENA SOUTHWEST FAMILY HEALTH CENTER
Practice Address - Street 2:1339 S. FEDERAL BLVD
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219
Practice Address - Country:US
Practice Address - Phone:303-602-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CODR.0061819208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program