Individual
TIMOTHY V SAMUELSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3200 PROVIDENCE DR, ANCHORAGE, AK 99508-4661
(907) 261-3111
(907) 565-8066
Mailing address
3427 E TUDOR RD, SUITE A, ANCHORAGE, AK 99507-1282
(907) 565-8005
(907) 565-8066
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
1008
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD1188
—
AK
Enumeration date
10/03/2005
Last updated
07/08/2007
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