Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 47627 | CO |
N | 208800000X | Urologist | 4791 | NE |
NPI | 1023137940 |
---|---|
Provider Name | Caleb J Stepan |
First Address | Grand Junction, CO 81505-9641 |
Second Address | Grand Junction, CO 81505-9641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 23/01/2020 |