Individual
TREVOR VAN OOSTROM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 S WOODWORTH LOOP, PALMER, AK 99645-8984
(907) 745-0374
(907) 745-0200
Mailing address
PO BOX 853, PALMER, AK 99645-0853
(907) 745-0374
(907) 745-0200
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5592
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI9459
GROUPS RR MCR#
AK
05
—
MD0271
—
AK
05
—
MDG417
—
AK
01
—
P00283147
VANOO RAILROAD MCR#
AK
Enumeration date
05/12/2006
Last updated
07/09/2007
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