Individual
BENJAMIN MALLICOAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5955 ZEAMER AVE, ANCHORAGE, AK 99506-3702
(937) 208-2007
Mailing address
5955 ZEAMER AVE, ANCHORAGE, AK 99506-3702
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01089128A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/22/2020
Last updated
08/19/2024
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