Pankow, Andrew D

Pankow, Andrew D is an individual health care provider with primary practice located at 3100 Tongass Ave , Ketchikan AK 99901-5746. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Pankow, Andrew D can be contacted via phone (907) 228-8140.

Contact Information

Primary practice address
3100 Tongass Ave Ketchikan AK 99901-5746
Phone: (907) 228-8140
Fax: (907) 228-8440
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 3306 Alaska

Profile Details

NPI number 1790711992
LBN Legal business name Pankow, Andrew D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Oct 12th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790711992 NPPES
Washington Other 201209 WASHINGTON L&I
Washington MEDICAID MD33061 WASHINGTON L&I

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