Healthcare Provider Details

I. General information

NPI: 1639145923
Provider Name (Legal Business Name): ALAN LESTER ROSENBERG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 W CONEJOS PL #424
DENVER CO
80204-1333
US

IV. Provider business mailing address

4200 W CONEJOS PL #424
DENVER CO
80204-1333
US

V. Phone/Fax

Practice location:
  • Phone: 303-629-3865
  • Fax:
Mailing address:
  • Phone: 303-629-3865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number15588
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: