Provider Demographics
NPI:1184673345
Name:STURTEVANT, LINDA R (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:R
Last Name:STURTEVANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7851 S ELATI ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-8080
Mailing Address - Country:US
Mailing Address - Phone:303-759-0854
Mailing Address - Fax:303-759-0864
Practice Address - Street 1:2222 N NEVADA AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6831
Practice Address - Country:US
Practice Address - Phone:719-766-5333
Practice Address - Fax:719-766-5651
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO35238207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01352384Medicaid
COCOA101937Medicare PIN
COF74656Medicare UPIN