Individual
STEPHEN J. MACDADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1100 BALSAM AVE, BOULDER, CO 80304-3404
(303) 440-2037
(303) 306-7753
Mailing address
PO BOX 173894, DENVER, CO 80217-3894
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DR.0053326
CO
207P00000X
Emergency Medicine Physician
TRN14664
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20058233
—
CO
01
—
P01346154
RAILROAD MEDICARE
CO
01
—
P01373711
RAILROAD MEDICARE
CO
Enumeration date
05/03/2010
Last updated
07/07/2015
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