Provider Demographics
NPI:1831181502
Name:CHROSTOWSKI, GREGORY K (MD)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:K
Last Name:CHROSTOWSKI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10240 W INDIAN SCHOOL RD
Mailing Address - Street 2:STE 155
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-5909
Mailing Address - Country:US
Mailing Address - Phone:623-594-3171
Mailing Address - Fax:623-594-3161
Practice Address - Street 1:10240 WEST INDIAN SCHOOL RD
Practice Address - Street 2:SUITE 155
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037
Practice Address - Country:US
Practice Address - Phone:623-385-7900
Practice Address - Fax:623-792-1232
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2022-07-27
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Provider Licenses
StateLicense IDTaxonomies
AZ31975207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ815483Medicaid
AZH95124Medicare UPIN
AZ815483Medicaid