Provider Demographics
NPI:1588717656
Name:CONAWAY, CASS WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:CASS
Middle Name:WILLIAM
Last Name:CONAWAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31098 BIG BEAR DR
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-9679
Mailing Address - Country:US
Mailing Address - Phone:303-674-5626
Mailing Address - Fax:303-674-6434
Practice Address - Street 1:721 19TH ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-2500
Practice Address - Country:US
Practice Address - Phone:303-623-1020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO243452086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery