Provider Demographics
NPI:1255305074
Name:COLAN, STEVEN DONALD (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:DONALD
Last Name:COLAN
Suffix:
Gender:M
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:PO BOX 845628
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-5628
Mailing Address - Country:US
Mailing Address - Phone:603-893-9784
Mailing Address - Fax:603-893-8886
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-6793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA45128208000000X, 2080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30001169Medicaid
MA7500121OtherUNITED HEALTHCARE MA
NY1098719Medicaid
CT003054392Medicaid
NC7610392Medicaid
RISC03665Medicaid
MA99254901OtherNETWORK HEALTH
MAAA9210OtherHARVARD PILGRIM
MAB20086501OtherCIGNA MA
MAE05286OtherBCBS MA
NH30001169Medicaid
MAE05286OtherBCBS MA