Provider Demographics
NPI:1063617876
Name:RUMACK, BARRY H
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:H
Last Name:RUMACK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 SILVER FOX CIR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80121-2129
Mailing Address - Country:US
Mailing Address - Phone:303-773-3354
Mailing Address - Fax:720-294-1281
Practice Address - Street 1:33 SILVER FOX CIR
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80121-2129
Practice Address - Country:US
Practice Address - Phone:303-773-3354
Practice Address - Fax:720-294-1281
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17145208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
COD23205Medicare UPIN