Provider Demographics
NPI:1326004797
Name:POPKIN, STEPHEN MARC (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:MARC
Last Name:POPKIN
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 1:4100 E MISSISSIPPI AVENUE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-3048
Mailing Address - Country:US
Mailing Address - Phone:303-759-3215
Mailing Address - Fax:720-870-3969
Practice Address - Street 1:4100 E MISSISSIPPI AVENUE
Practice Address - Street 2:SUITE 600
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-3048
Practice Address - Country:US
Practice Address - Phone:303-759-3215
Practice Address - Fax:720-870-3969
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO225212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01225218Medicaid
CO73431OtherBLUE SHIELD
COC73431Medicare PIN