Individual
PETER O MJOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3300 PROVIDENCE DR, SUITE B314, ANCHORAGE, AK 99508-4690
(907) 212-3420
Mailing address
PO BOX 196276, ANCHORAGE, AK 99519-6276
(907) 212-6522
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1553
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
162616
MEDICARE MD GROUP #
AK
05
—
MD15151
—
AK
Enumeration date
10/20/2006
Last updated
09/09/2013
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