Organization
DAVID M. WITHAM MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID M WITHAM M.D. (PRESIDENT)
(907) 452-5527
Entity
Organization
Contact information
Practice address
1411 19TH AVE, FAIRBANKS, AK 99701-5902
(907) 457-4900
(907) 457-4913
Mailing address
1411 19TH AVE, FAIRBANKS, AK 99701-5902
(907) 457-4900
(907) 457-4913
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
4607
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457328197
PERSONAL NPI
—
Enumeration date
08/22/2007
Last updated
08/22/2007
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