Individual
DR. STEPHEN EDWARD GODAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
231 PROSPECT AVE, SUITE A, FORT MORGAN, CO 80701
(970) 867-4911
Mailing address
PO BOX 905, FORT MORGAN, CO 80701
(970) 867-4911
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34790
CO
208000000X
Pediatrics Physician
34790
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21227039
—
CO
Enumeration date
07/28/2006
Last updated
04/02/2008
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