Sovndal, Shannon Smith

Sovndal, Shannon Smith is an individual health care provider with primary practice located at 1100 Balsam Ave , Boulder CO 80304-3404. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Sovndal, Shannon Smith can be contacted via phone (303) 440-2037.

Contact Information

Primary practice address
1100 Balsam Ave Boulder CO 80304-3404
Phone: (303) 440-2037
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 41265 Colorado
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X DR.0041265 Colorado

Profile Details

NPI number 1912984394
LBN Legal business name Sovndal, Shannon Smith
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2005
Last updated Feb 14th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912984394 NPPES
Colorado MEDICAID 86032330
Colorado Other P00019485

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