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Individual

DR. MARY ALICE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3340 PROVIDENCE DR, SUITE 366, ANCHORAGE, AK 99508-4616
(907) 563-3026
(907) 562-6445
Mailing address
3340 PROVIDENCE DR, SUITE 366, ANCHORAGE, AK 99508-4616
(907) 563-3026
(907) 562-6445

Taxonomy

Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
3976
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
AK
Enumeration date
08/19/2006
Last updated
07/09/2007
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