Individual
SHANTELL M TWOBEARS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1551 PROFESSIONAL LN UNIT 170, LONGMONT, CO 80501-6971
(303) 773-9000
Mailing address
1551 PROFESSIONAL LN UNIT 280, LONGMONT, CO 80501-6965
(303) 773-9000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7807
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-26972
MEDICA
—
05
—
10470
—
ND
01
—
28202
BLUE CROSS BLUE SHIELD
ND
01
—
932G4TW
BLUE CROSS BLUE SHIELD
MN
01
—
B20861015426
PREFERRED ONE
—
01
—
HP29359
HEALTHPARTNERS
—
Enumeration date
07/22/2006
Last updated
12/13/2021
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