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Individual

MICHELE O'FALLON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4048 LAUREL ST, ANCHORAGE, AK 99508-5333
(907) 770-7800
(907) 929-4660
Mailing address
4048 LAUREL ST, ANCHORAGE, AK 99508-5391
(907) 770-7800
(907) 929-4660

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3566
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
710889996
TAX ID
AK
Enumeration date
01/26/2006
Last updated
03/01/2010
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