Provider Demographics
NPI:1689788184
Name:DUCHANIN, FAYE SAI (PAC)
Entity Type:Individual
Prefix:
First Name:FAYE
Middle Name:SAI
Last Name:DUCHANIN
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6307 DEBARR RD STE C
Mailing Address - Street 2:PATIENTS FIRST MEDICAL CLINIC
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-1783
Mailing Address - Country:US
Mailing Address - Phone:907-333-7425
Mailing Address - Fax:907-333-7719
Practice Address - Street 1:6307 DEBARR RD STE C
Practice Address - Street 2:PATIENTS FIRST MEDICAL CLINIC
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-1783
Practice Address - Country:US
Practice Address - Phone:907-333-7425
Practice Address - Fax:907-333-7719
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK665363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1730113739OtherGROUP NPI
AKMDA0056Medicaid
AK665OtherSTATE LICENSE
AK665OtherSTATE LICENSE