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
Phone: (907) 486-6065
Fax: (907) 486-2248
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417920497 | NPPES |
| Alaska | MEDICAID | MD1478 |
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