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General NPI Number Information
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NPI Number | 1356526776
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Entity Type | Organization
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Legal Business Name | ROCKY MOUNTAIN PEDIATRIC PULMONOLOGY PC
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Dates
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Enumeration Date | 01/03/2008
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Last Update Date | 01/03/2008
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Provider Practice Location Address
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Address Line | 4545 E 9TH AVE STE 375
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City | DENVER
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State | CO
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Zip | 80220-3987
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Country | US
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Telephone | 303-831-9853
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Fax |
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Provider Business Mailing Address
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Address Line | 4545 E 9TH AVE STE 375
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City | DENVER
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State | CO
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Zip | 80220-3987
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MD
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Name | LEE RUSAKOW
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Credential | MD
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Telephone | 303-831-9853
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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