Healthcare Provider Details

I. General information

NPI: 1437545928
Provider Name (Legal Business Name): WOJCIECH GWARNICKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2015
Last Update Date: 01/23/2020
Certification Date: 01/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 E MAPLEWOOD AVE STE 200
GREENWOOD VILLAGE CO
80111-4727
US

IV. Provider business mailing address

16472 E OTERO AVE
ENGLEWOOD CO
80112-4622
US

V. Phone/Fax

Practice location:
  • Phone: 303-438-3999
  • Fax: 720-439-9500
Mailing address:
  • Phone: 847-849-6543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberDR.0062354
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: