Healthcare Provider Details

I. General information

NPI: 1578095436
Provider Name (Legal Business Name): JOHN DAVID DRAMINSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2017
Last Update Date: 11/23/2020
Certification Date: 11/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 N PLUM ST
FRUITA CO
81521-2100
US

IV. Provider business mailing address

PO BOX 130
FRUITA CO
81521-0130
US

V. Phone/Fax

Practice location:
  • Phone: 970-858-9894
  • Fax: 970-858-1331
Mailing address:
  • Phone: 970-858-2186
  • Fax: 970-858-2208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.061209
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: