Withrow, Mark Edward

Withrow, Mark Edward is an individual health care provider with primary practice located at 1818 E Rezanof Dr , Kodiak AK 99615. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Withrow, Mark Edward can be contacted via phone (907) 486-6065.

Contact Information

Primary practice address
1818 E Rezanof Dr Kodiak AK 99615
Fax: (907) 486-2248
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X AA1478 Alaska

Profile Details

NPI number 1417920497
LBN Legal business name Withrow, Mark Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2006
Last updated Jul 8th, 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 1417920497 NPPES
Alaska MEDICAID MD1478

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