Provider Demographics
NPI:1942759998
Name:POPE-ROLEWSKI, STEPHEN NORRIS (PA)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:NORRIS
Last Name:POPE-ROLEWSKI
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13780 DEL CORSO WAY APT 1713
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-8416
Mailing Address - Country:US
Mailing Address - Phone:520-440-8124
Mailing Address - Fax:
Practice Address - Street 1:10535 PARK MEADOWS BLVD
Practice Address - Street 2:SUITE #301
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-8012
Practice Address - Country:US
Practice Address - Phone:303-662-8250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-30
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0005933363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant