Provider Demographics
NPI:1710170717
Name:OWENS, STEPHANIE M (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:M
Last Name:OWENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4500 E 9TH AVE STE 470
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3923
Mailing Address - Country:US
Mailing Address - Phone:303-320-8499
Mailing Address - Fax:303-320-8620
Practice Address - Street 1:4650 W 38TH AVE STE 215
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-2161
Practice Address - Country:US
Practice Address - Phone:303-320-8499
Practice Address - Fax:303-320-8620
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD429655207V00000X
CO46540207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO88682838Medicaid
COCOA100022Medicare PIN