Provider Demographics
NPI:1295726024
Name:ROTHENBERG, STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:ROTHENBERG
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 1:2055 N HIGH ST STE 370
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5545
Mailing Address - Country:US
Mailing Address - Phone:303-839-6001
Mailing Address - Fax:303-839-6033
Practice Address - Street 1:2055 N HIGH ST STE 370
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5545
Practice Address - Country:US
Practice Address - Phone:303-839-6001
Practice Address - Fax:303-839-6033
Is Sole Proprietor?:No
Enumeration Date:2005-11-01
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2508782086S0120X
CO274392086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY1295726024Medicaid
CO01274398Medicaid
NE10025550600Medicaid
SD1295726024Medicaid
CO01274398Medicaid
ND14262Medicaid
AZ693230Medicaid
MT1295726024Medicaid
MT1295726024Medicaid
AZ693230Medicaid
CO525592YLK2Medicare PIN