Provider Demographics
NPI:1912237058
Name:KLUBO-GWIEZDZINSKA, JOANNA (MD, PHD)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:KLUBO-GWIEZDZINSKA
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NIH NIDDK BUILDING 10 CRC 10 CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-1613
Mailing Address - Country:US
Mailing Address - Phone:240-688-3589
Mailing Address - Fax:
Practice Address - Street 1:NIH NIDDK BUILDING 10 CRC 10 CENTER DR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-1613
Practice Address - Country:US
Practice Address - Phone:240-688-3589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-13
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
DCMD043529207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program