Individual
DAYNA FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1915 E REZANOF DR, KODIAK, AK 99615-6602
(907) 486-9521
Mailing address
PO BOX 3706, PORTLAND, OR 97208-3706
(866) 907-1068
(425) 917-9141
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3972
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013759
—
AK
Enumeration date
05/01/2007
Last updated
10/25/2017
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