Individual
DR. ROGER PAUL ILVONEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2337 S YOUNGFIELD WAY, LAKEWOOD, CO 80228-4970
(303) 986-2827
(303) 986-5720
Mailing address
2337 S YOUNGFIELD WAY, LAKEWOOD, CO 80228-4970
(303) 986-2827
(303) 986-5720
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
18649
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1186493
—
CO
Enumeration date
04/15/2009
Last updated
04/15/2009
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