Provider Demographics
NPI:1730342742
Name:KOLODZIE, KERSTIN (MD)
Entity type:Individual
Prefix:DR
First Name:KERSTIN
Middle Name:
Last Name:KOLODZIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1600 DIVISADERO ST
Mailing Address - Street 2:C 355, BOX 1605
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3010
Mailing Address - Country:US
Mailing Address - Phone:415-885-7842
Mailing Address - Fax:415-885-7770
Practice Address - Street 1:1600 DIVISADERO ST
Practice Address - Street 2:C 355, BOX 1605
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3010
Practice Address - Country:US
Practice Address - Phone:415-885-7842
Practice Address - Fax:415-885-7770
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA123219207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology