Provider Demographics
NPI:1194016733
Name:RELLAS, STEPHEN DALE (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:DALE
Last Name:RELLAS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1300 RIVERSIDE AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-4351
Mailing Address - Country:US
Mailing Address - Phone:970-224-1670
Mailing Address - Fax:970-495-6218
Practice Address - Street 1:2121 E HARMONY RD
Practice Address - Street 2:SUITE 370
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-3400
Practice Address - Country:US
Practice Address - Phone:970-221-2290
Practice Address - Fax:970-295-0036
Is Sole Proprietor?:No
Enumeration Date:2011-05-01
Last Update Date:2021-09-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO51995207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine