Provider Demographics
NPI:1275898470
Name:MOTUZKO, ELENA (MD)
Entity Type:Individual
Prefix:DR
First Name:ELENA
Middle Name:
Last Name:MOTUZKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:OLENA
Other - Middle Name:
Other - Last Name:GILEYKOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX #2010
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81602-2010
Mailing Address - Country:US
Mailing Address - Phone:970-945-7564
Mailing Address - Fax:970-945-0563
Practice Address - Street 1:1906 BLAKE AVENUE
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601
Practice Address - Country:US
Practice Address - Phone:970-945-7564
Practice Address - Fax:970-945-0563
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.00609142085N0700X
PAMD4612862085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology