# DWAYNE E TRUJILLO MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922128677
- **Authorized official:** JOSEPH E BEATY (BILLING AGENT)
- **Authorized official phone:** (907) 770-2301

## Contact information

- **Practice address:** 4001 DALE ST, SUITE 216, ANCHORAGE, AK 99508-5428
- **Practice address phone:** (907) 569-3600
- **Practice address fax:** (907) 569-3200
- **Mailing address:** PO BOX 241769, ANCHORAGE, AK 99524-1769
- **Mailing address phone:** (907) 770-2380
- **Mailing address fax:** (907) 770-2325

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/29/2007
- **Last updated:** 10/10/2007