Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 26645 | CO |
NPI | 1295780252 |
---|---|
Provider Name | Dr. Stephen Alan Goldstein |
First Address | Englewood, CO 80112-5137 |
Second Address | Englewood, CO 80112-5137 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01266451 | (05) | CO |
D24824 | (02) | CO |