Provider Demographics
NPI:1548311822
Name:REWEY, RICHARD W (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:W
Last Name:REWEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:6081 S QUEBEC ST STE 203
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4538
Mailing Address - Country:US
Mailing Address - Phone:303-220-8859
Mailing Address - Fax:303-220-8865
Practice Address - Street 1:6081 S QUEBEC ST STE 203
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80111-4538
Practice Address - Country:US
Practice Address - Phone:303-220-8859
Practice Address - Fax:303-220-8865
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO160352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC75881Medicare PIN