Provider Demographics
NPI:1730488099
Name:NEW, STEPHEN M (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:M
Last Name:NEW
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 1:4500 E 9TH AVE
Mailing Address - Street 2:STE 720S
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3926
Mailing Address - Country:US
Mailing Address - Phone:303-355-3525
Mailing Address - Fax:303-355-0255
Practice Address - Street 1:4500 E 9TH AVE STE 720S
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3926
Practice Address - Country:US
Practice Address - Phone:303-355-3525
Practice Address - Fax:303-355-0255
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CODR0058061207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty