Healthcare Provider Details

I. General information

NPI: 1528845542
Provider Name (Legal Business Name): PIOTR ARTHUR POCZWARDOWSKI PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2023
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10375 PARK MEADOWS DR STE 100
LONE TREE CO
80124-6736
US

IV. Provider business mailing address

1805 SHEA CENTER DR STE 450
HIGHLANDS RANCH CO
80129-2255
US

V. Phone/Fax

Practice location:
  • Phone: 303-225-0025
  • Fax: 303-225-0029
Mailing address:
  • Phone: 303-357-2559
  • Fax: 303-225-0029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0008106
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: