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MR. STEPHEN MATTHEW SHORTRIDGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
3066 E MERIDIAN PARK LOOP, WASILLA, AK 99654-7372
(907) 373-9460
(907) 373-9461
Mailing address
3066 E MERIDIAN PARK LOOP, WASILLA, AK 99654-7372
(907) 373-9460
(907) 373-9461

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
394
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1020264
AK
Enumeration date
08/26/2006
Last updated
09/29/2015
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