Provider Demographics
NPI:1427442698
Name:FUSSNER, STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:FUSSNER
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 1:1511 ONYX CIR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-7805
Mailing Address - Country:US
Mailing Address - Phone:303-776-5298
Mailing Address - Fax:303-682-2785
Practice Address - Street 1:1511 ONYX CIR
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80504-7805
Practice Address - Country:US
Practice Address - Phone:303-776-5298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ612312084N0400X
SC843002084N0400X
TXS23042084N0400X
MI43015026612084N0400X
NY304855-012084N0400X
CO00619742084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology