Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 3587 | AK |
N | 207YP0228X | Pediatric Otolaryngology | 3587 | AK |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 3587 | AK |
NPI | 1952311425 |
---|---|
Provider Name | Donald R. Endres |
First Address | Anchorage, AK 99508-5051 |
Second Address | Anchorage, AK 99508-5051 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G15139 | (02) | AK |
MD1661 | (05) | AK |