Organization
HERITAGE FAMILY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER SAHLSTROM MD (OWNER)
(907) 982-5300
Entity
Organization
Contact information
Practice address
4961 E MAYFLOWER LN, WASILLA, AK 99654-7708
(907) 376-5337
Mailing address
4931 E MAYFLOWER LN, SUITE 1, WASILLA, AK 99654-7759
(907) 376-5337
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6506
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD0506
—
AK
05
—
MPG0164
—
AK
Enumeration date
12/17/2009
Last updated
03/15/2021
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