Individual
MR. SAMUEL DEBLAUW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1717 W COWLES ST, FAIRBANKS, AK 99701-5926
(907) 451-6682
(907) 459-3811
Mailing address
1717 W COWLES ST, CHIEF ANDREW ISAAC HEALTH CENTER, FAIRBANKS, AK 99701-5926
(907) 451-6682
(907) 459-3811
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1234
AK
Other
Enumeration date
12/04/2014
Last updated
06/25/2015
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