Provider Demographics
NPI:1720051873
Name:FELDMANN, LOUANN (MD)
Entity Type:Individual
Prefix:
First Name:LOUANN
Middle Name:
Last Name:FELDMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3435 E TUDOR RD
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1282
Mailing Address - Country:US
Mailing Address - Phone:907-770-7078
Mailing Address - Fax:907-646-0670
Practice Address - Street 1:3435 E TUDOR RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-1282
Practice Address - Country:US
Practice Address - Phone:907-770-7078
Practice Address - Fax:907-646-0670
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1869208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD9994Medicaid
AK152556Medicare PIN
AK152557Medicare PIN
C04336Medicare UPIN