Unknown Individual – Family Medicine Physician, NPI 1750307740
Family Medicine Physician
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NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
East Rezanof Drive, Kodiak, Kodiak Island, Alaska, 99615, United States
KODIAK, AK 996156602
Phone: (907) 486-3781
Fax: (907) 486-9586
Type: Location
615 6th St SE
Stanley, ND 587844444
Phone: (701) 628-2505
Type: Location
3706, Northeast Maywood Place, Maywood Park, Portland, Metro, Multnomah County, Oregon, 97220, United States
PORTLAND, OR 972083706
Phone: (866) 907-1068
Fax: (425) 917-9141
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 99615)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine, Family Practice, Internal Medicine | MI | |
| - | ND | |
| - | MN | |
| Nurse Practitioner | ND | |
| Nurse Practitioner | ND | |
| Internal Medicine | ND | |
| Nurse Practitioner | ND | |
| Physician Assistant | SD | |
| General Surgery, Emergency Medicine, Emergency Medicine | ND |
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