MEDICARE: ALEKSANDRA GRZESZCZAK DEIBEL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	04-37451	KS

General Provider Information

NPI Number	:	1134459621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEKSANDRA GRZESZCZAK DEIBEL M.D.

Provider Business Mailing Address
First Line	:	3333 S WADSWORTH BLVD UNIT D160
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80227-5131
Country	:	US
Telephone Number	:	850-778-2795
Fax Number	:	850-807-5096

Provider Business Practice Location Address
First Line	:	3333 S WADSWORTH BLVD UNIT D160
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80227-5131
Country	:	US
Telephone Number	:	850-778-2795
Fax Number	:	850-807-5096

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2010
Last Update Date	:	12/29/2023

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