Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 19672 | MN |
N | 207T00000X | Neurosurgeon | 4301102267 | MI |
Y | 207T00000X | Neurosurgeon | DR.0056315 | CO |
NPI | 1083768139 |
---|---|
Provider Name | Christopher D Roark |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-2545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 08/02/2016 |