Provider Demographics
NPI:1164415691
Name:CONWAY, DAVID R (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:CONWAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:205 S GARRISON ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-2843
Mailing Address - Country:US
Mailing Address - Phone:720-728-5170
Mailing Address - Fax:720-866-9967
Practice Address - Street 1:7780 S BROADWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2648
Practice Address - Country:US
Practice Address - Phone:303-798-9996
Practice Address - Fax:303-730-1145
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO37704207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO7492083OtherAETNA PPO
CO84099770807OtherPACIFICARE
CO9147746001OtherCIGNA
CO114679OtherAETNA HMO
CO59885866Medicaid
COF3878Medicare ID - Type Unspecified