Provider Demographics
NPI:1689081416
Name:KAMADA- HIGA, STACIE LEIGH (DO)
Entity Type:Individual
Prefix:
First Name:STACIE
Middle Name:LEIGH
Last Name:KAMADA- HIGA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:STACIE
Other - Middle Name:LEIGH
Other - Last Name:KAMADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:9100 E MINERAL CIR FL 2
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:303-649-6954
Practice Address - Street 1:2350 MEADOWS BLVD
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-8405
Practice Address - Country:US
Practice Address - Phone:720-455-0655
Practice Address - Fax:720-455-0065
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COTL00005255207R00000X
CODR.0056101208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist