Provider Demographics
NPI:1730210733
Name:AMMON, STEFEN M (MD)
Entity type:Individual
Prefix:
First Name:STEFEN
Middle Name:M
Last Name:AMMON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1241 W MINERAL AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-5685
Mailing Address - Country:US
Mailing Address - Phone:303-759-0854
Mailing Address - Fax:303-759-0864
Practice Address - Street 1:7700 S BROADWAY
Practice Address - Street 2:LITTLETON ADVENTIST HOSPITAL, EMERGENCY DEPT.
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2602
Practice Address - Country:US
Practice Address - Phone:303-778-5666
Practice Address - Fax:303-778-5787
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2020-05-15
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Provider Licenses
StateLicense IDTaxonomies
COCDRH.0045573207P00000X
AZ58357207P00000X
NV18674207P00000X
IDMC-0362207P00000X
CO45573207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP00442365OtherRR MEDICARE
CO45607753Medicaid
COC809460Medicare PIN