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Individual

MR. STEVEN M FORDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
7300 KLAWOCK-HOLLIS HIGHWAY, KLAWOCK, AK 99925-0069
(907) 755-4800
(907) 755-4981
Mailing address
PO BOX 69, KLAWOCK, AK 99925-0069
(907) 254-0850

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 2831
FL
363AM0700X
Medical Physician Assistant
981
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
981
ALASKA LICENSE
AK
05
MDA0419
AK
01
PA 2831
FLORIDA LICENSE PA-C
FL
Enumeration date
08/05/2006
Last updated
01/08/2013
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