Organization
ANCHORAGE PEDIATRIC GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES RYAN MD (SENIOR PARTNER)
(907) 562-2423
Entity
Organization
Contact information
Practice address
3340 PROVIDENCE DR, STE 500, ANCHORAGE, AK 99508-4616
(907) 562-2423
Mailing address
3340 PROVIDENCE DR, STE 500, ANCHORAGE, AK 99508-4616
(907) 562-2423
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
1744
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD1116
—
AK
05
—
MD1744
—
AK
05
—
MD2694
—
AK
05
—
MD3035
—
AK
05
—
MD3158
—
AK
Enumeration date
07/10/2006
Last updated
08/22/2020
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