Healthcare Provider Details

I. General information

NPI: 1437136637
Provider Name (Legal Business Name): LISA ROHWER NOWAK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 11/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 E 19TH AVE SUITE 3950
DENVER CO
80218-1216
US

IV. Provider business mailing address

1601 E 19TH AVE SUITE 3950
DENVER CO
80218-1216
US

V. Phone/Fax

Practice location:
  • Phone: 303-539-0736
  • Fax: 303-539-0737
Mailing address:
  • Phone: 303-539-0736
  • Fax: 303-539-0737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number38681
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: