Individual
DR. MARK E. AGNEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3300 PROVIDENCE DR, B314, ANCHORAGE, AK 99508-4690
(907) 212-3420
(907) 212-3429
Mailing address
PO BOX 4105, PORTLAND, OR 97208-4105
(866) 907-1068
(425) 917-9141
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
1145
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009656
—
AK
Enumeration date
10/02/2006
Last updated
04/19/2016
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