Provider Demographics
NPI:1508827791
Name:SANTANGELO, STEPHEN M (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:M
Last Name:SANTANGELO
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 1:1260 S YORK ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-1913
Mailing Address - Country:US
Mailing Address - Phone:720-810-8384
Mailing Address - Fax:303-777-5619
Practice Address - Street 1:1260 S YORK ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-1913
Practice Address - Country:US
Practice Address - Phone:303-704-1801
Practice Address - Fax:303-777-5619
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44371207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO38889374Medicaid
MA2092158Medicaid
CO38889374Medicaid
MA2092158Medicaid
A37953Medicare ID - Type Unspecified