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Individual

DAEYOUNG D ROH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
15492 E PRENTICE DR, CENTENNIAL, CO 80015-4267
(817) 296-9180
(817) 421-6252
Mailing address
15492 E PRENTICE DR, CENTENNIAL, CO 80015-4267
(817) 296-9180
(817) 421-6252

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
DR.0051910
CO
207R00000X
Internal Medicine Physician
G62251
CA
207R00000X
Internal Medicine Physician
M3075
TX
207RN0300X
Nephrology Physician
M3075
TX
208M00000X
Hospitalist Physician
Primary
G62251
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
179849801
TX
05
179849802
TX
05
179849803
TX
05
179849805
TX
01
63503514
MEDICAID
CO
01
8S5106
BCBS
TX
Enumeration date
05/18/2006
Last updated
10/19/2022
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