Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 44678 | CO |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 44678 | CO |
NPI | 1679528541 |
---|---|
Provider Name | Dr. Steven D Sides |
First Address | Greeley, CO 80631-5114 |
Second Address | Greeley, CO 80631-5114 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 21/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20539266 | (05) | CO |
I52902 | (02) | CO |