Provider Demographics
NPI:1003846197
Name:ANTHES, V MALURKAR (MD)
Entity Type:Individual
Prefix:
First Name:V
Middle Name:MALURKAR
Last Name:ANTHES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VICKY
Other - Middle Name:
Other - Last Name:MALURKAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3524 TONGASS AVE
Mailing Address - Street 2:P O BOX 8653
Mailing Address - City:KETCHIKAN
Mailing Address - State:AK
Mailing Address - Zip Code:99901-5635
Mailing Address - Country:US
Mailing Address - Phone:907-225-9830
Mailing Address - Fax:907-225-9840
Practice Address - Street 1:3524 TONGASS AVE
Practice Address - Street 2:
Practice Address - City:KETCHIKAN
Practice Address - State:AK
Practice Address - Zip Code:99901-5635
Practice Address - Country:US
Practice Address - Phone:907-225-9830
Practice Address - Fax:907-225-9840
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1473207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1473OtherLICENSE
AKMD14731Medicaid
AK1473OtherLICENSE
AKF58211Medicare UPIN