Individual
DR. RANDY L VANANTWERP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2801 DEBARR RD, DEPARTMENT OF PATHOLOGY, ANCHORAGE, AK 99508-2932
(907) 264-1171
(907) 264-1702
Mailing address
PO BOX 140987, ANCHORAGE, AK 99514-0987
(907) 345-0004
(907) 561-1953
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
3473
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GRO825
—
AK
05
—
MD1801
—
AK
Enumeration date
08/30/2006
Last updated
07/09/2007
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