Organization
ADVANCED MEDICAL GROUP
Active
Organization
ADVANCED MEDICAL GROUP
Active
Other names
Advanced Cosmetic Dermatology, Advanced Dermatolgoy
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARINA IGOREVNA LUPAS (MANAGER)
(907) 691-4977
Entity
Organization
Contact information
Practice address
135 W DIMOND BLVD STE 104C, ANCHORAGE, AK 99515-1907
(907) 691-4977
(907) 313-7450
Mailing address
PO BOX 230508, ANCHORAGE, AK 99523-0508
(907) 691-4977
(907) 313-7450
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
—
—
207NP0225X
Pediatric Dermatology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
261Q00000X
Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
07/21/2020
Last updated
01/28/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up