Individual
MARVIN GRENDAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3500 LATOUCHE ST, SUITE 230, ANCHORAGE, AK 99508-4209
(907) 561-1917
(907) 563-5373
Mailing address
3500 LATOUCHE ST, SUITE 230, ANCHORAGE, AK 99508-4209
(907) 561-1917
(907) 563-5373
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD1417
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD1417
—
AK
Enumeration date
09/01/2006
Last updated
07/08/2007
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