Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 5028 | AK |
NPI | 1073509063 |
---|---|
Provider Name | Dr. Jeremy J Gitomer |
First Address | Anchorage, AK 99519-6800 |
Second Address | Anchorage, AK 99508-5211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 19/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1017876 | (05) | AK |