Individual
MARIUS MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3650 LAKE OTIS PKWY, SUITE 202, ANCHORAGE, AK 99508-5218
(907) 222-6500
(907) 222-6550
Mailing address
3650 LAKE OTIS PARKWAY, STE 202, ANCHORAGE, AK 99508-0000
(907) 222-6500
(907) 222-6550
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
5262
SD
207T00000X
Neurological Surgery Physician
Primary
7202
AK
207T00000X
Neurological Surgery Physician
MD2011-0824
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119113600
—
WY
01
—
24245
ND BCBS PIN
ND
01
—
312588
WYOMING BCBS PIN
WY
05
—
3505619
—
MT
01
—
4995818
WELLMARK BCBS PIN
SD
05
—
6100890
—
SD
Enumeration date
03/21/2006
Last updated
06/02/2014
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