Individual
GENIE ROOSEVELT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
777 BANNOCK ST, DENVER, CO 80204-4507
(303) 602-3300
Mailing address
PO BOX 876, AURORA, CO 80040-0876
(303) 493-7000
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
39854
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23179732
—
CO
Enumeration date
10/25/2006
Last updated
05/09/2024
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