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Individual

DR. NATHAN ROESNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2595 CANYON BLVD STE 360, BOULDER, CO 80302-6745
(303) 440-7546
Mailing address
11700 W 2ND PL, MEDICAL PLAZA 2 STE 210, LAKEWOOD, CO 80228-1704
(303) 909-6977
(303) 954-4779

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
50492
CO
208600000X
Surgery Physician
5101017089
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
75531267
CO
Enumeration date
04/02/2007
Last updated
10/20/2021
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