NPI | 1376835355 |
---|---|
Doing Business As | MEADOW CREEK DERMATOLOGY |
Entity Type | Organization |
Authorized Contact | THOMAS A FENGER Owner 907-694-3303 |
Organization Subpart ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AK 423) |
Enumeration Date | 2011-05-09 |
Last Update Date | 2011-05-09 |