Provider Demographics
NPI:1912121245
Name:BUCHHOLZ, CURTIS L
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:L
Last Name:BUCHHOLZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44455 STERLING HWY
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7936
Mailing Address - Country:US
Mailing Address - Phone:907-262-3557
Mailing Address - Fax:907-262-6505
Practice Address - Street 1:44455 STERLING HWY
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7936
Practice Address - Country:US
Practice Address - Phone:907-262-3557
Practice Address - Fax:907-262-6505
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAK 4229207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKK 151267Medicare PIN