Mark Dziemianowicz, MD
in Greeley, CO. Individual provider (NPI-1).
NPI number1154776029
StatusActive
Last updated in NPPESFeb 10, 2025
Details
- NPI
- 1154776029
- Entity type
- Individual (NPI-1)
- Name
- Mark Dziemianowicz
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 28, 2016
- Certification date
- Jan 2, 2024
- Last updated
- Feb 10, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0001X | DR0072435 | CO | Yes | |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | |
| 2085R0001X | 13549A | WY |
Practice location
1801 16th StGreeley, CO 80631
Phone 970-810-3894 · Fax 970-810-3897
Mailing address
1801 16th StGreeley, CO 80631
Phone 970-810-3894 · Fax 970-810-3897
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