Individual
STEFAN J. CHIMOSKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3601 ARAPAHOE AVE, UNIT D180, BOULDER, CO 80303-1584
(720) 845-5858
(505) 288-3642
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2001156
NM
207QS1201X
Sleep Medicine (Family Medicine) Physician
Primary
0052058
CO
207QS1201X
Sleep Medicine (Family Medicine) Physician
2001-156
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35424737
—
NM
Enumeration date
10/03/2006
Last updated
06/12/2020
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