Provider Demographics
NPI:1437209822
Name:YOUNG, SHAWN E (MD)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:E
Last Name:YOUNG
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 1:1825 MARION ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1122
Mailing Address - Country:US
Mailing Address - Phone:303-318-3464
Mailing Address - Fax:303-318-3437
Practice Address - Street 1:1825 MARION ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1122
Practice Address - Country:US
Practice Address - Phone:303-318-3464
Practice Address - Fax:303-318-3437
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO438382086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO72123788Medicaid
CO807157Medicare PIN
CO72123788Medicaid