Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 138182 | AK |
NPI | 1215371430 |
---|---|
Provider Name | Alan Swenson |
First Address | Anchorage, AK 99508-5234 |
Second Address | Anchorage, AK 99508-5234 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2013 |
Last Update Date | 25/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1696227 | (05) | AK |