Organization
MARVIN JOHN GRENDAHL MD A PROFESSIONAL CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GAIL LEINGANG (OFFICE ADMIN.)
(907) 561-1917
Entity
Organization
Contact information
Practice address
3500 LATOUCHE ST STE 280, ANCHORAGE, AK 99508-4261
(907) 561-1917
(907) 563-5373
Mailing address
3500 LATOUCHE ST STE 280, ANCHORAGE, AK 99508-4261
(907) 561-1917
(907) 563-5373
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD1417
AK
207W00000X
Ophthalmology Physician
MD3686
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD1417
—
AK
Enumeration date
12/04/2007
Last updated
11/22/2011
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