MEDICARE: MARIA C DZIAMSKI MD

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	207L00000X	Anesthesiology Physician	036095969	IL
2	207L00000X	Anesthesiology Physician	39538	WI

General Provider Information

NPI Number	:	1639158298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA C DZIAMSKI MD

Provider Business Mailing Address
First Line	:	2251 NORTH SHORE DRIVE
Second Line	:
City	:	RHINELANDER
State	:	WI
Zip	:	54501-8360
Country	:	US
Telephone Number	:	715-361-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2251 NORTH SHORE DRIVE
Second Line	:
City	:	RHINELANDER
State	:	WI
Zip	:	54501-8360
Country	:	US
Telephone Number	:	715-361-2000
Fax Number	:

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

Provider Enumeration Date	:	01/12/2006
Last Update Date	:	01/23/2025

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