Individual
DR. ANNA GABRIELA KONICEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
126 E HOMESTEAD DR, BASALT, CO 81621-5033
(970) 989-9597
Mailing address
PO BOX 11084, ASPEN, CO 81612-9659
(970) 989-9597
(844) 350-6556
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
DO2023-1082
NM
207Q00000X
Family Medicine Physician
Primary
OS9734
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A13552
STATE MEDICAL LICENSE
CA
01
—
234719
STATE LICENSE NUMBER
NY
01
—
45287
COLORADO STATE MEDICAL LICENSE
CO
01
—
OS9734
STATE LICENSE NUMBER
FL
Enumeration date
01/05/2007
Last updated
11/04/2024
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