| 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 |