Provider Demographics
NPI:1790001899
Name:ALWARD, PETER FRITZ (ANP)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:FRITZ
Last Name:ALWARD
Suffix:
Gender:M
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17601 BEAUJOLAIS DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7515
Mailing Address - Country:US
Mailing Address - Phone:907-242-9639
Mailing Address - Fax:
Practice Address - Street 1:1500 DEBARR CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2984
Practice Address - Country:US
Practice Address - Phone:907-865-7102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKU 1113363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health