Provider Demographics
NPI:1891797809
Name:KORSHIN, OLIVER (MD)
Entity Type:Individual
Prefix:DR
First Name:OLIVER
Middle Name:
Last Name:KORSHIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 AIRPORT HTS DR #310
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2975
Mailing Address - Country:US
Mailing Address - Phone:907-276-8838
Mailing Address - Fax:907-258-0735
Practice Address - Street 1:1200 AIRPORT HTS DR #310
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2975
Practice Address - Country:US
Practice Address - Phone:907-276-8838
Practice Address - Fax:907-258-0735
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA1849207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD1849Medicaid
AKK0000BHTMFMedicare ID - Type UnspecifiedMEDICARE ID
AKMD1849Medicaid