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General NPI Number Information
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NPI Number | 1871230789
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Entity Type | Organization
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Legal Business Name | SOUTH DENVER GASTROENTEROLOGY, PC
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Dates
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Enumeration Date | 05/13/2022
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Last Update Date | 05/13/2022
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Provider Practice Location Address
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Address Line | 499 E HAMPDEN AVE STE 420
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City | ENGLEWOOD
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State | CO
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Zip | 80113-2794
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Country | US
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Telephone | 303-788-8888
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Fax |
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Provider Business Mailing Address
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Address Line | 499 E HAMPDEN AVE STE 420
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City | ENGLEWOOD
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State | CO
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Zip | 80113-2794
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Country | US
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Telephone | 303-788-8888
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | RICHARD M ROMAN
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Credential |
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Telephone | 303-406-4275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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