Individual
ANDREW D PANKOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3100 TONGASS AVE, KETCHIKAN, AK 99901-5746
(907) 228-8140
(907) 228-8440
Mailing address
3100 TONGASS AVE, KETCHIKAN, AK 99901-5746
(907) 228-8300
(907) 228-8518
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3306
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201209
WASHINGTON L&I
WA
05
—
MD33061
—
AK
Enumeration date
06/23/2006
Last updated
10/12/2007
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