Provider Demographics
NPI:1417934928
Name:BRIAN F SWEENEY MD APC
Entity Type:Organization
Organization Name:BRIAN F SWEENEY MD APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADELLA
Authorized Official - Middle Name:K
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:NCMA
Authorized Official - Phone:907-562-2829
Mailing Address - Street 1:4120 LAUREL ST
Mailing Address - Street 2:STE 201
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508
Mailing Address - Country:US
Mailing Address - Phone:907-562-2928
Mailing Address - Fax:907-563-4848
Practice Address - Street 1:4120 LAUREL ST
Practice Address - Street 2:STE 201
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-562-2928
Practice Address - Fax:907-563-4848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK4461207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK4461Medicaid
151317Medicare ID - Type Unspecified
AK4461Medicaid