Individual
DR. ANDREY YUSUPOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4076 NEELY RD, FORT WAINWRIGHT, AK 99703
(907) 361-5024
Mailing address
2008B SOUTHERN AVE, FAIRBANKS, AK 99709-4237
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD-17154
HI
Other
Enumeration date
06/07/2011
Last updated
06/25/2018
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