Provider Demographics
NPI:1588649511
Name:STOFAN, MICHAEL JAMES (MSPT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JAMES
Last Name:STOFAN
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7555 E ARAPAHOE RD
Mailing Address - Street 2:STE 2
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1290
Mailing Address - Country:US
Mailing Address - Phone:303-694-1245
Mailing Address - Fax:303-694-1254
Practice Address - Street 1:7555 E ARAPAHOE RD
Practice Address - Street 2:STE 2 HERITAGE HEALTH
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-1290
Practice Address - Country:US
Practice Address - Phone:303-694-1245
Practice Address - Fax:303-694-1254
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO7383225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COST662380OtherBLUE CROSS BLUE SHIELD
COST662380OtherBLUE CROSS BLUE SHIELD