Provider Demographics
NPI:1942315668
Name:FABIAN, STEVEN L (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:L
Last Name:FABIAN
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 1:9777 S YOSEMITE ST STE 110
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-3115
Mailing Address - Country:US
Mailing Address - Phone:720-696-0852
Mailing Address - Fax:720-696-0892
Practice Address - Street 1:9777 S YOSEMITE ST STE 110
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-3115
Practice Address - Country:US
Practice Address - Phone:720-696-0852
Practice Address - Fax:720-696-0892
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0041503207RN0300X
MA234691174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO00251861Medicaid
COH83950Medicare UPIN
CO498418Medicare ID - Type Unspecified