Provider Demographics
NPI:1275734592
Name:STANFORD, CHERYL ELAINE (MD)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ELAINE
Last Name:STANFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:ELAINE
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:950 E HARVARD AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-7006
Mailing Address - Country:US
Mailing Address - Phone:303-649-3200
Mailing Address - Fax:303-765-6201
Practice Address - Street 1:950 E HARVARD AVE STE 200
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-7006
Practice Address - Country:US
Practice Address - Phone:303-649-3200
Practice Address - Fax:303-765-6201
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2017-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME105547207Q00000X
CODR.0058372207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006615301Medicaid
FL006615301Medicaid
207Q00000XMedicare PIN