Individual
TIMOTHY STIDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13123 E 16TH AVE, AURORA, CO 80045-7106
(720) 777-1234
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
48502
CO
2080P0203X
Pediatric Critical Care Medicine Physician
48502
CO
2080P0203X
Pediatric Critical Care Medicine Physician
59214
MT
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
MD2019-0698
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43622771
—
CO
Enumeration date
07/18/2007
Last updated
03/04/2024
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