Provider Demographics
NPI:1578621017
Name:KESSELMAN, STEPHEN E (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:E
Last Name:KESSELMAN
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 1:750 POTOMAC ST STE 223
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-6744
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:303-751-5850
Practice Address - Street 1:750 POTOMAC ST STE 223
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-6744
Practice Address - Country:US
Practice Address - Phone:303-777-3277
Practice Address - Fax:303-751-5850
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20203207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01202035Medicaid
COC49251Medicare ID - Type Unspecified
CO01202035Medicaid