Provider Demographics
NPI:1639445323
Name:PADGETT, SHANNON VALURRIE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:VALURRIE
Last Name:PADGETT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:255 UNION BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1833
Mailing Address - Country:US
Mailing Address - Phone:303-763-5111
Mailing Address - Fax:303-302-2355
Practice Address - Street 1:255 UNION BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1833
Practice Address - Country:US
Practice Address - Phone:303-763-5111
Practice Address - Fax:303-302-2355
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2016-10-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CODR.0056077207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO518771XYUZMedicare PIN