Provider Demographics
NPI:1669772265
Name:RICHARD W. REWEY, MD, PC
Entity type:Organization
Organization Name:RICHARD W. REWEY, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:REWEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-220-8859
Mailing Address - Street 1:6081 S QUEBEC ST STE 203
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4538
Mailing Address - Country:US
Mailing Address - Phone:303-220-8859
Mailing Address - Fax:303-220-8865
Practice Address - Street 1:6081 S QUEBEC ST STE 203
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80111-4538
Practice Address - Country:US
Practice Address - Phone:303-220-8859
Practice Address - Fax:303-220-8865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO160352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC75881Medicare PIN