Provider Demographics
NPI:1598714404
Name:HUFF, STEFANIE A (MD)
Entity Type:Individual
Prefix:DR
First Name:STEFANIE
Middle Name:A
Last Name:HUFF
Suffix:
Gender:F
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:PO BOX 5788
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-5788
Mailing Address - Country:US
Mailing Address - Phone:303-202-1280
Mailing Address - Fax:
Practice Address - Street 1:100 HEALTH PARK DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-9583
Practice Address - Country:US
Practice Address - Phone:720-321-4161
Practice Address - Fax:720-321-4165
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE23359207PE0004X
OH35-085058207PE0004X
VT042-0011037207PE0004X
WAMD00045332207PE0004X
IA36635207PE0004X
CO45391207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA3593913Medicaid
NE42068035512Medicaid
IAI17844Medicare ID - Type Unspecified
COCOAAA4022Medicare PIN
I36780Medicare UPIN