Provider Demographics
NPI:1518100437
Name:STUEVEN, JEREMY ARTHUR (MD)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:ARTHUR
Last Name:STUEVEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JEREMY
Other - Middle Name:ARTHUR
Other - Last Name:STUEVEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, MBA
Mailing Address - Street 1:155 E. BOARDWALK DRIVE #406
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525
Mailing Address - Country:US
Mailing Address - Phone:970-493-3800
Mailing Address - Fax:
Practice Address - Street 1:1024 S LEMAY AVE
Practice Address - Street 2:EMERGENCY PHYSICIANS OF THE ROCKIES
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3929
Practice Address - Country:US
Practice Address - Phone:303-306-7783
Practice Address - Fax:303-306-7753
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY8956A207P00000X
NMMD2011-0607207P00000X
CO51921207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO72639563Medicaid
CO277236YLA0Medicare PIN