Basic Information
Provider Information
NPI: 1649433574
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOPOLKO
FirstName: ALEXANDRIA
MiddleName: SERGEJEVNA
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: DUBINKINA
OtherFirstName: ALEXANDRIA
OtherMiddleName: SERGEJEVNA
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: 11600 W 2ND PL
Address2:  
City: LAKEWOOD
State: CO
PostalCode: 802281527
CountryCode: US
TelephoneNumber: 7203210000
FaxNumber:  
Practice Location
Address1: 11600 W 2ND PL
Address2:  
City: LAKEWOOD
State: CO
PostalCode: 802281527
CountryCode: US
TelephoneNumber: 7203210000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/10/2008
LastUpdateDate: 08/13/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XDR.0050437COY Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000XDR.0050437CON Allopathic & Osteopathic PhysiciansHospitalist 

ID Information
IDTypeStateIssuerDescription
3070487105CO MEDICAID
P0153127001COMEDICARE RAILROADOTHER


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