Provider Demographics
NPI:1073590758
Name:STEVENS, STEPHANIE SIGGARD (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:SIGGARD
Last Name:STEVENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:SIGGARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3300 S PARKER RD STE 404
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3529
Mailing Address - Country:US
Mailing Address - Phone:720-974-7149
Mailing Address - Fax:720-974-7175
Practice Address - Street 1:5657 S HIMALAYA ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-5307
Practice Address - Country:US
Practice Address - Phone:303-699-6200
Practice Address - Fax:720-460-4783
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO39603208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO82255237Medicaid
I01180Medicare UPIN
519838Medicare ID - Type Unspecified