Provider Demographics
NPI:1194711994
Name:CROWLEY, STEPHEN THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:THOMAS
Last Name:CROWLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-750-0822
Mailing Address - Fax:303-750-1298
Practice Address - Street 1:1444 S POTOMAC ST
Practice Address - Street 2:SUITE 300
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4508
Practice Address - Country:US
Practice Address - Phone:303-750-0822
Practice Address - Fax:303-750-1298
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO29214207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01292143Medicaid
NE10026280800Medicaid
NE10026281000Medicaid
NE10026280700Medicaid
NE10026281200Medicaid
NE1982948089Medicaid
KS100171660CMedicaid
CO273637YPNQOtherMEDICARE
NE10026280600Medicaid
NE10026283100Medicaid
WY1194711994Medicaid
NENA2301014Medicare PIN
NE1982948089Medicaid
CO273637YN6LMedicare PIN
COF99731Medicare UPIN
NE10026281200Medicaid
NE10026283100Medicaid
COC438488Medicare PIN