Individual
DR. LAWRENCE WILLIAM ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2955 S BROADWAY, ENGLEWOOD, CO 80113-1526
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
47008
CO
207R00000X
Internal Medicine Physician
G79450
CA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
G79450
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G794500
—
CA
01
—
019508
KAISER COMMERCIAL NUMBER
CO
05
—
09759221
—
CO
Enumeration date
09/14/2006
Last updated
05/07/2021
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