DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. STEPHANIE M DETTLEBACH, M.D.

Active

DR. STEPHANIE M DETTLEBACH, M.D. is a Family Medicine healthcare provider located in LONGMONT, Colorado. NPI 1629145990 is currently active in the NPPES registry. Verify at CMS.

Family Medicine · LONGMONT, CO

Registration Details

NPI Number
1629145990
Provider Type
Individual
Gender
Female
NPI Issued
Nov 29, 2006 (19.710113594979 yrs)
Last Updated
Jul 12, 2016
Licenses
2009012781 (MO)
DR.0057193 (CO)

Practice Information

Address
1925 MOUNTAIN VIEW AVE
LONGMONT, CO, 805013128
Browse CO providers · Browse ZIP 80501
Phone
3037761234
Fax
7204943107
Primary Specialty
Family Medicine
207Q00000X
Additional Specialty
Family Medicine

Other Family Medicine Providers in LONGMONT, CO

Name Credential NPI
SUSAN I ROACH MD 1467454694
MARK LAITOS MD 1992707129
MARY E FAINI MD 1144222373
CHRISTOPHER C MADDEN MD 1689676819
DR. MARK WALLACE HINMAN M.D. 1750385415
DR. DAVID BRITT MD 1427052836
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.