Provider Demographics
NPI:1497169155
Name:RYDER, STEPHANIE COWHERD (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:COWHERD
Last Name:RYDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:LYNN
Other - Last Name:COWHERD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1700 N WHEELING ST
Mailing Address - Street 2:K-1-11SC
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045
Mailing Address - Country:US
Mailing Address - Phone:720-723-3300
Mailing Address - Fax:
Practice Address - Street 1:1700 N WHEELING ST
Practice Address - Street 2:K-1-11SC
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045
Practice Address - Country:US
Practice Address - Phone:720-723-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COTL.000527208100000X
COTL.0005271390200000X
CODR.0058385208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program