Provider Demographics
NPI:1194197582
Name:MODE, STEPHEN (RDCS)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:MODE
Suffix:
Gender:M
Credentials:RDCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 E SPEER BLVD
Mailing Address - Street 2:SUITE 15
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-3719
Mailing Address - Country:US
Mailing Address - Phone:303-478-0302
Mailing Address - Fax:844-605-3324
Practice Address - Street 1:825 E SPEER BLVD
Practice Address - Street 2:SUITE 15
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-3719
Practice Address - Country:US
Practice Address - Phone:303-478-0302
Practice Address - Fax:844-605-3324
Is Sole Proprietor?:No
Enumeration Date:2015-10-23
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COARDMS358902471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography