Individual
DANIEL ALBERT CIESLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
49TH MEDICAL GROUP/SGOPF, 280 FIRST STREET, BLDG 23, HOLLOMAN AFB, NM 88330-8273
(575) 572-7091
(575) 572-2259
Mailing address
49TH MEDICAL GROUP/SGOPF, 280 FIRST STREET, BLDG 23, HOLLOMAN AFB, NM 88330-8273
(575) 572-7091
(575) 572-2259
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28880
NE
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/04/2014
Last updated
04/09/2018
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