Provider Demographics
NPI:1104025865
Name:GIESKE, BRADLEY (MD)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:
Last Name:GIESKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 E MAPLEWOOD AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4727
Mailing Address - Country:US
Mailing Address - Phone:352-867-8898
Mailing Address - Fax:352-732-6282
Practice Address - Street 1:1227 LAKE PLAZA DR STE B
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-7402
Practice Address - Country:US
Practice Address - Phone:719-448-0981
Practice Address - Fax:719-448-0767
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2018-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COME42784207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO90236769Medicaid
CO809474OtherBLUE CROSS BLUE SHIELD
CO90236769Medicaid