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Individual

DR. MATTHEW J. STEPHENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1400 JACKSON ST, DENVER, CO 80206-2761
(303) 388-4461
(303) 270-2206
Mailing address
PO BOX 636256 CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 245-3107
(513) 585-5511

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
54455
CO
208D00000X
General Practice Physician
01068794A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
139854
SIHO-NICC
KY
05
99379368
CO
Enumeration date
08/19/2009
Last updated
02/20/2018
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