Provider Demographics
NPI:1003914094
Name:MD INC
Entity Type:Organization
Organization Name:MD INC
Other - Org Name:ALASKA PREMIER HEALTH ALASKA SPORTS MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MAPES
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:907-561-3488
Mailing Address - Street 1:3300 ARCTIC BLVD
Mailing Address - Street 2:101
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503
Mailing Address - Country:US
Mailing Address - Phone:907-561-3488
Mailing Address - Fax:907-562-3488
Practice Address - Street 1:3300 ARCTIC BLVD
Practice Address - Street 2:101
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503
Practice Address - Country:US
Practice Address - Phone:907-561-3488
Practice Address - Fax:907-562-3488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1286207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty