Individual
NICHOLAS A VAN LITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3300 PROVIDENCE DR STE B314, ANCHORAGE, AK 99508-4621
(907) 212-3420
(907) 212-3429
Mailing address
PO BOX 4105, PORTLAND, OR 97208-4105
(866) 907-1068
(425) 917-9141
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
100987
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1630677
—
AK
Enumeration date
05/07/2015
Last updated
11/09/2020
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