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Organization

ALEX R. CUDKOWICZ, M.D.,P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ATHANASSIOS PAPAIOANU MD (PRESIDENT & CEO)
(615) 916-3200
Entity
Organization

Contact information

Practice address
1011 N MILDRED RD, CORTEZ, CO 81321
(970) 565-8482
(970) 565-8478
Mailing address
658 GRASSMERE PARK STE 104, NASHVILLE, TN 37211-3683
(615) 916-3217
(615) 916-3218

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
34477
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06D2089339
CLIA
CO
01
21901
BLUE CROSS/BLUE SHIELD ID
CO
05
291602679011
UT
05
445066
AZ
05
74779354
CO
05
Q4652
NM
Enumeration date
01/17/2006
Last updated
12/29/2021
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