MR. MARK EDWARD WITHROW MD NPI 1417920497

NPI Information

NPI: 1417920497
Provider Name: MR. MARK EDWARD WITHROW, MD
Classification: General Practice - 208D00000X
Entity Type: Individual
Address:
1818 E REZANOF DR
KODIAK, AK
ZIP 99615
Phone: (907) 486-6065
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MR. Mark Edward Withrow, MD is a general practice in Kodiak, AK. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee MR. Mark Edward Withrow, MD NPI is 1417920497. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1818 E REZANOF DR
KODIAK, AK
ZIP 99615
Phone: (907) 486-6065
Fax: (907) 486-2248

The enumeration date for this NPI number is 2/9/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice		AA1478	ALASKA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	01WCHHTA	MEDICARE ID-TYPE UNSPECIFIED	ALASKA
2	MD1478	MEDICAID	ALASKA
3	C96975	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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