Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 6987 | AK |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 6987 | AK |
NPI | 1184675126 |
---|---|
Provider Name | Mark E Flanum |
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 | 15/05/2006 |
Last Update Date | 29/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1019990 | (05) | AK |