Provider Demographics
NPI:1184607772
Name:ROONEY, ANNA M (MD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:M
Last Name:ROONEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:5450 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2709
Mailing Address - Country:US
Mailing Address - Phone:303-415-7599
Mailing Address - Fax:303-530-5474
Practice Address - Street 1:6685 GUNPARK DR
Practice Address - Street 2:STE 110
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-3388
Practice Address - Country:US
Practice Address - Phone:303-530-3062
Practice Address - Fax:303-530-5474
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO37519207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO48134287Medicaid
CO080173992Medicare PIN
COG82407Medicare UPIN
CO48134287Medicaid