Individual
CARLA MICHELLE CARTAGENA DE JESUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1001 NOBLE ST STE 1, FAIRBANKS, AK 99701-4991
(907) 459-3500
Mailing address
PO BOX 73720, FAIRBANKS, AK 99707-3720
(907) 459-3500
(907) 459-3526
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
143269
AK
208000000X
Pediatrics Physician
R75496
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1698143
—
AK
Enumeration date
04/28/2016
Last updated
09/24/2019
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