Basic Information
Provider Information
NPI: 1033559893
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DZIAMSKI
FirstName: ANNA
MiddleName: ELIZABETH
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8915 W CONNELL CT
Address2:  
City: MILWAUKEE
State: WI
PostalCode: 53226
CountryCode: US
TelephoneNumber: (414) 266-2000
FaxNumber:  
Practice Location
Address1: 8915 W CONNELL AVE
Address2:  
City: MILWAUKEE
State: WI
PostalCode: 532263067
CountryCode: US
TelephoneNumber: 4142662000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/26/2013
LastUpdateDate: 06/28/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X125-063162ILY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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