Provider Demographics
NPI:1316019474
Name:REEVES, MICHAEL S (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:REEVES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3801 UNIVERSITY LAKE DR STE 301
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4658
Mailing Address - Country:US
Mailing Address - Phone:907-777-1850
Mailing Address - Fax:855-468-1357
Practice Address - Street 1:3801 UNIVERSITY LAKE DR STE 301
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-777-1850
Practice Address - Fax:855-468-1357
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AK4371207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1014265Medicaid
AKBR6588860OtherDEA
AKBR6588860OtherDEA