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Individual

DR. THEODORE HARRY STATHOS

Active
Find providers by NPI
Individual

DR. THEODORE HARRY STATHOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
33634
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01336346
CO
01
04018362
GROUP MEDICAID
CO
01
109864100
GROUP MEDICAID
WY
05
1144265315
WY
01
1699895755
GROUP NPI
01
18498
MEDICAL LICENSE
NE
01
200293420 A
GROUP MEDICAID
OK
05
200295450 A
OK
01
33634
MEDICAL LICENSE
CO
01
8301A
MEDICAL LICENSE
WY
01
84127410413
GROUP MEDICAID
NE
Enumeration date
06/19/2006
Last updated
09/28/2010
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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