Shane Rothermel, MD
Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery in Pueblo, CO. Individual provider (NPI-1).
NPI number1083000541
StatusActive
Last updated in NPPESOct 30, 2021
Details
- NPI
- 1083000541
- Entity type
- Individual (NPI-1)
- Name
- Shane Rothermel
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 11, 2015
- Certification date
- Oct 30, 2021
- Last updated
- Oct 30, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207XS0114X | Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery | DR0065962 | CO | Yes |
| 207XS0114X | Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery | 25MA10759000 | NJ | |
| 207XS0114X | Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery | MD462106 | PA | |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
3676 Parker Blvd Ste 390Pueblo, CO 81008-2215
Phone 719-595-7780 · Fax 719-595-7789
Mailing address
2500 English Creek Ave Ste 1300Egg Harbor Township, NJ 08234-5598
Phone 609-677-7013 · Fax 609-677-7000
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