Bautista, Marciano David
Bautista, Marciano David is an individual health care provider with primary practice located at Mile 187.5 Glenn Hwy , Glennallen AK 99588-0589. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bautista, Marciano David can be contacted via phone (907) 822-3203.Contact Information
Primary practice address
Mile 187.5 Glenn Hwy
Glennallen AK 99588-0589
Phone: (907) 822-3203
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 35579 | Colorado |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 4535 | Alaska |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 5101013320 | Michigan |
Profile Details
| NPI number | 1114078995 |
|---|---|
| LBN Legal business name | Bautista, Marciano David |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 16th, 2007 |
| Last updated | Mar 31st, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114078995 | NPPES |
| Alaska | Other | P00673381 | MEDICARE RAILROAD PTAN |
| Alaska | Other | 1114078995 | MEDICARE RAILROAD PTAN |
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