Individual
MICHAEL TYLER COLESAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
688 6TH ST, FORT RICHARDSON, AK 99505
(541) 399-1269
Mailing address
1060 GAFFNEY RD, FORT WAINWRIGHT, AK 99703-5002
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
195381
AK
Other
Enumeration date
04/13/2019
Last updated
12/15/2022
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