Provider Demographics
NPI:1811022239
Name:SNIVELY, STEVEN LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:LEE
Last Name:SNIVELY
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 1:601 E HAMPDEN AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2788
Mailing Address - Country:US
Mailing Address - Phone:303-788-6445
Mailing Address - Fax:303-788-5363
Practice Address - Street 1:601 E HAMPDEN AVE STE 200
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2788
Practice Address - Country:US
Practice Address - Phone:303-788-6445
Practice Address - Fax:303-788-5363
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.00271442086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01271444Medicaid
CO408379ZN0DOtherMEDICARE PTAN
CO408379N0DMedicare PIN