Provider Demographics
NPI:1679664338
Name:BILAN, MARK A (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:BILAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:261 E 26TH AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2707
Mailing Address - Country:US
Mailing Address - Phone:907-569-1123
Mailing Address - Fax:907-569-1180
Practice Address - Street 1:400 W NORTHERN LIGHTS BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3877
Practice Address - Country:US
Practice Address - Phone:907-569-1123
Practice Address - Fax:907-569-1180
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK232111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKK160460Medicare ID - Type UnspecifiedMEDICARE
AKU16871Medicare UPIN