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MARVIN GRENDAHL MD
>> Ophthalmology >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1871695791
Individual Registrant: MARVIN GRENDAHL MD
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
3500 LATOUCHE ST SUITE 230 ANCHORAGE, AK 99508-4209 US
Tel: 907-561-1917 Fax: 907-563-5373
Tel: 907-561-1917 Fax: 907-563-5373
Contact information for business:
3500 LATOUCHE ST SUITE 230 ANCHORAGE, AK 99508-4209 US
Tel: 907-561-1917 Fax: 907-563-5373
Tel: 907-561-1917 Fax: 907-563-5373
Registration Information:
NPI: 1871695791
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207W00000X | Allopathic & Osteopathic Physicians Ophthalmology | AK | MD1417 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| MD1417 | AK | 05 |
