Provider Demographics
NPI:1871646257
Name:DWORETSKY, STEVEN (MD)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:DWORETSKY
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 1:7600 E ORCHARD RD
Mailing Address - Street 2:SUITE 120S
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2518
Mailing Address - Country:US
Mailing Address - Phone:303-721-8821
Mailing Address - Fax:303-721-8820
Practice Address - Street 1:7600 E ORCHARD RD
Practice Address - Street 2:SUITE 120S
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2518
Practice Address - Country:US
Practice Address - Phone:303-721-8821
Practice Address - Fax:303-721-8820
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO242002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01242007Medicaid
CO01242007Medicaid
D28346Medicare UPIN