Provider Demographics
NPI:1053390419
Name:ROSCKOWFF, CAROL M (MD)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:M
Last Name:ROSCKOWFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6565 S SYRACUSE WAY APT 301
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-6751
Mailing Address - Country:US
Mailing Address - Phone:720-524-4928
Mailing Address - Fax:720-242-8337
Practice Address - Street 1:6565 S SYRACUSE WAY APT 301
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-6751
Practice Address - Country:US
Practice Address - Phone:720-524-4928
Practice Address - Fax:720-242-8337
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ33019208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics