Provider Demographics
NPI:1215109970
Name:SWEENEY, ELIZABETH G (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:G
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF COLORADO SCHOOL OF MEDICINE
Mailing Address - Street 2:4200 E. 9TH AVE
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80262-0001
Mailing Address - Country:US
Mailing Address - Phone:303-315-7424
Mailing Address - Fax:
Practice Address - Street 1:15101 E ILIFF AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-4543
Practice Address - Country:US
Practice Address - Phone:303-996-9601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CO49848208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO85200727Medicaid