Individual
NATHAN PAUL BASTIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4076 NEELY RD, FT WAINWRIGHT, AK 99703
(907) 361-5172
Mailing address
4076 NEELY RD, FT WAINWRIGHT, AK 99703
(907) 361-5172
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0101265428
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/19/2017
Last updated
09/30/2024
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