Provider Demographics
NPI:1497722284
Name:ROSENBERG, STUART G (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:G
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 UNION BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1813
Mailing Address - Country:US
Mailing Address - Phone:303-951-0600
Mailing Address - Fax:303-951-0605
Practice Address - Street 1:274 UNION BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1813
Practice Address - Country:US
Practice Address - Phone:303-951-0600
Practice Address - Fax:303-951-0605
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO28261207RC0200X, 207LC0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04594040Medicaid
KS200389140AMedicaid
WA8464588Medicaid
CO01282615Medicaid
WA8464588Medicaid
COCQ2008Medicare PIN