Provider Demographics
NPI:1760505333
Name:STEADMAN, ROBERT SHANE (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SHANE
Last Name:STEADMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3646 S GALAPAGO ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-3421
Mailing Address - Country:US
Mailing Address - Phone:303-781-5617
Mailing Address - Fax:303-781-1045
Practice Address - Street 1:3646 S GALAPAGO ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-3421
Practice Address - Country:US
Practice Address - Phone:303-781-5617
Practice Address - Fax:303-781-1045
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5404111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO499578Medicare PIN
COV07700Medicare UPIN