Individual
DR. DANIEL JOHN COVERDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11470 BUSINESS BLVD, SUITE 100, EAGLE RIVER, AK 99577-7721
(907) 622-4325
(907) 622-4326
Mailing address
15217 DARBY RD, EAGLE RIVER, AK 99577-9211
(907) 622-5584
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4780
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4780
STATE LICENSE #
AK
05
—
MD6231
—
AK
05
—
MD63211
—
AK
Enumeration date
12/08/2006
Last updated
07/09/2007
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