Individual
DERRICK ANTHONY MANZLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3976 UNIVERSITY LAKE DR STE 100, ANCHORAGE, AK 99508-4644
(907) 729-8141
(907) 729-3998
Mailing address
3976 UNIVERSITY LAKE DR STE 100, ANCHORAGE, AK 99508-4644
(907) 729-8141
(907) 729-3998
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
261728
MA
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
Primary
0101262628
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235429457
—
VA
Enumeration date
04/08/2011
Last updated
10/13/2022
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