Individual
MITCHELL RYAN ANDREAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
4076 NEELY RD; BLDG 4076; ROOM 1B-201, FORT WAINWRIGHT, AK 80906-4102
(907) 361-4000
Mailing address
4076 NEELY ROAD, FORT WAINWRIGHT, AK 99703
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
233899
AK
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1761500
—
AK
Enumeration date
10/04/2018
Last updated
03/13/2026
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