Provider Demographics
NPI:1912910928
Name:FLATIRONS ENDOCRINOLOGY CONSULTANTS PC
Entity Type:Organization
Organization Name:FLATIRONS ENDOCRINOLOGY CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:STJERNHOLM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-440-0444
Mailing Address - Street 1:36 GARDEN CTR
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-1730
Mailing Address - Country:US
Mailing Address - Phone:303-465-0401
Mailing Address - Fax:303-404-2317
Practice Address - Street 1:1155 ALPINE AVE
Practice Address - Street 2:SUITE 260
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3495
Practice Address - Country:US
Practice Address - Phone:303-440-0444
Practice Address - Fax:303-444-2015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR15809174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04007183Medicaid
CO04007183Medicaid